Treatment of Acute Pancreatitis in The Emergency Room: What Should be Done During the First Hours of Disease?

Acute pancreatitis (AP) is among the most common gastrointestinal causes of hospital admission in the United States, with nearly 250 000 hospitalizations annually at a cost of US$2.6 billion. This chapter focuses on early management of AP in the emergency room within the first few hours of presentation. This includes prompt accurate diagnosis, evaluation for possible etiology, and role of prophylactic antibiotics, urgent endoscopic retrograde cholangiopancreatography, nutrition and fluid resuscitation, all very critical for patient outcomes. Acute abdominal pain is one of the common complaints among patients presenting to the emergency room. Prompt specialist consultation should be sought for patients with AP. Initiating judicious early aggressive fluid resuscitation is the cornerstone of management of AP. Pancreatitis, a potentially fatal disease, can be managed effectively in the first few hours of presentation and this can change the natural course of disease towards a better outcome.