Acute Pancreatitis

UCLA provides personalized treatment and minimally invasive diagnosis for patients with acute pancreatitis. Our surgical team is one of the most experienced in the region. Non-surgical treatment options are also available.

What Is Acute Pancreatitis?

Acute pancreatitis is a painful condition involving inflammation of the pancreas. For 90 percent of patients, episodes of acute pancreatitis resolve on their own within a week.

Severe pancreatitis occurs in roughly 10 percent of cases. It is often associated with pancreatic necrosis (death of pancreatic tissue).

Other complications of acute pancreatitis include:

• Pancreatic cysts (pseudocysts)
• Pancreatic abscess
• Pancreatic fistula

What Is a Pseudocyst?

Pseudocysts are a complication of acute pancreatitis. The majority of these benign (non-cancerous) cysts get better on their own.

In roughly 5 percent of patients, they can develop into chronic pseudocysts that require drainage or surgical removal. Learn more about pancreatic cysts.

What Is a Pancreatic Abscess?

A pancreatic abscess is a pus-filled cavity with little or no necrosis involved. It is different from an infected pancreatic pseudocyst and is diagnosed with CT scan and FNA (fine needle aspiration). FNA involves placing a small needle into the cavity to take a fluid sample.

Non-surgical tube drainage is often effective in treating a pancreatic abscess. If this doesn’t improve your condition, surgical drainage may be required.

What Is a Pancreatic Fistula?

A pancreatic fistula (small opening) can develop as a result of acute pancreatitis or as a complication of surgery. Most pancreatic fistulas close on their own. Those that do not may require surgery to repair them.

What Causes Acute Pancreatitis?

The most common cause of acute pancreatitis is gallstone disease. In these cases, patients may benefit from gallbladder removal. Acute pancreatitis is also associated with heavy alcohol use.

Acute Pancreatitis Symptoms

Symptoms of acute pancreatitis include:

• Abdominal pain and swelling
• Nausea
• Vomiting
• Fever
• Rapid pulse

Diagnosing Pancreatic Necrosis

Pancreatic necrosis is a serious condition that increases your risk of infection, which can ultimately lead to organ failure and death.

Doctors diagnose pancreatic infection with both CT (computerized tomography) scan and ultrasound-guided FNA. In this procedure, doctors insert a small needle directly into the cyst to collect a sample. If bubbles are visible on the CT scan, this means infection is present, and FNA is not required.

Pancreatic Necrosis Treatment

For patients who have dead tissue that is not infected, the condition can be managed without surgery. Where infection is present, however, surgery often represents the best chance for recovery.

Except when a patient’s condition is deteriorating rapidly, surgeons will typically wait a week or two before operating. This is because waiting for the severe inflammation to pass typically results in better outcomes for patients. 

In some cases, the dead tissue may be removed endoscopically. This minimally invasive procedure uses a thin, flexible tube (endoscope) inserted into the digestive tract to remove the tissue, instead of surgery.

Surgery for Infected Pancreatic Necrosis

Surgery is aimed at removing infected tissue and draining excess fluid. Surgeons may also place drains in several areas to help with post-operative care. 

The most common complications of this surgery are bleeding and intestinal fistula. Most intestinal fistulas close on their own without surgery.

Pancreatic necrosis associated with infection traditionally has been associated with a mortality rate of roughly 20 to 25 percent. However, evidence suggests early diagnosis and newer treatment approaches, including endoscopic therapy and minimally invasive surgery, can lower those rates and improve a patient’s chances of survival.