Severe acute pancreatitis

Key points• Severe acute pancreatitis is a potentially life-threatening condition that can cause multi-organ failure • Early initiation of supportive treatment and determination of severity to identify patients in, or at risk of, organ failure to provide them with timely critical care support aimed at reversing organ failure are critical • Lack of understanding about the natural course of the disease and limited treatment targets are a concern • The cornerstones of management of acute pancreatitis are fluid resuscitation, adequate pain relief, and the early initiation and maintenance of nutrition • The step-up approach is the preferred strategy for managing necrotizing pancreatitis, with endoscopic drainage preferred to surgical intervention