2. Diagnosis
• Requires the presences of two of the following three criteria:
• Acute onset of persistent, severe epigastric pain
• Elevation in lipase or amylase to > 3 times the upper limit of normal
• Findings of acute pancreatitis on imaging
• In patients with characteristic epigastric pain and elevation in lipase/amylase >3 times
normal, no imaging is required for diagnosis
• Lipase elevations occur earlier and last longer than amylase; more sensitive in patients
with alcoholic pancreatitis (parenchyma is unable to produce amylase in EtOH
pancreatitis)
3. Other causes for elevation in lipase
• Renal failure
• Acute cholecystitis
• Bowel obstruction or infarction
• Duodenal ulceration
• Pancreatic tumors
• DKA
• HIV
• Post-ERCP/trauma
• Celiac disease
• Idiopathic
4. Findings of acute pancreatitis on imaging
Heterogenous appearance of the pancreas
(arrow) and peripancreatic fat stranding
(arrowhead)
Homogenous pancreatic enhancement
(arrow) and peripancreatic necrosis
(arrowhead)