Acute pancreatitis: diagnosis and management.

Acute pancreatitis is a clinical syndrome characterized by midepigastric pain, nausea and vomiting. Numerous etiologies have been linked with this entity, principally alcoholism and biliary disease. Once the clinical suspicion of pancreatitis is confirmed, supportive therapy with intravenous hydration and close observation is effective in the vast majority of patients. Lack of improvement may indicate the need to search for a local complication such as pseudocyst or abscess. Fine-needle aspiration of suspected infected collections should be performed under computed tomographic guidance. Surgical intervention may be required if infection is confirmed. Evidence of the systemic complications of pancreatitis mandates intensive care monitoring.