Anton Vavrečka
Acute pancreatitis is an acute inflammation of pancreas with variable course, developing from autodigestion of pancreas. Prognosis depending mainly from two factors: from clinical forms of acute pancreatitis and from management of illness. Mild (oedematous) form does not need very intensive therapy and mortality is nearly zero. Severe (necrotic) form needs more aggressive therapy, mortality is much higher and in cases with infection of necrosis it achieves 20-30 %. The patient with acute pancreatitis needs hospitalization, quick determination of right diagnosis , monitoring of vital functions, early differentiation between biliary and non-biliary and mild and severe pancreatitis. Therapy is conservative: fasting, replacement of fluids and electrolytes, pain suppressing, and in severe forms also therapy with antibiotics. Application of antiproteases did not influence morbidity and mortality. Complications need to be treated symptomatically. Severe acute biliary pancreatitis may be treated also endoscopically. Surgery is indicated only in patients with infected necrosis and abscesses.