Acute Pancreatitis

Acute pancreatitis is an abrupt inflammatory injury to the pancreas. The first problem may look gastrointestinal—severe epigastric pain, vomiting, and abdominal tenderness—but the dangerous physiology is often circulatory and respiratory. Pancreatic inflammation increases capillary permeability, so fluid leaves the vascular space and collects in the retroperitoneum and peritoneal cavity. The resulting fall in effective circulating volume can produce hypotension, acute kidney injury, and shock; inflammatory mediators can also cause hypoxaemia, acute respiratory distress syndrome, and failure of other organs. The experienced nurse therefore watches the whole patient, not the lipase value alone: perfusion, urine output, work of breathing, oxygen requirement, mental status, abdominal distension, and the response to fluid therapy. Treatment is supportive but active—restore perfusion without causing fluid overload, control pain and vomiting, feed the gut early when possible, identify the cause, and escalate promptly when organ dysfunction persists.