[1] For patients with severe pancreatitis who cannot tolerate normal oral food consumption, a nasogastric tube is placed in the stomach.

[1][8] A procedure known as an endoscopic retrograde cholangiopancreatography (ERCP) may be done to examine the distal common bile duct and remove a gallstone if present.

[1] In chronic pancreatitis, in addition to the above, temporary feeding through a nasogastric tube may be used to provide adequate nutrition.

Unexplained weight loss may occur from a lack of pancreatic enzymes hindering digestion.

Blood loss, dehydration, and fluid leaking into the abdominal cavity (ascites) can lead to kidney failure.

Severe inflammation can lead to intra-abdominal hypertension and abdominal compartment syndrome, further impairing renal and respiratory function and potentially requiring management with an open abdomen to relieve the pressure.

[19] The mnemonic "GET SMASHED" is often used to help clinicians and medical students remember the common causes of pancreatitis: Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion sting, Hyperlipidemia, hypothermia or hyperparathyroidism, ERCP, Drugs (commonly azathioprine, valproic acid, liraglutide).

Birth control pills and HRT cause arterial thrombosis of the pancreas through the accumulation of fat (hypertriglyceridemia).

Meanwhile, thiazide diuretics cause hypertriglyceridemia and hypercalcemia, where the latter is the risk factor for pancreatic stones.

Meanwhile, antiretroviral drugs may cause metabolic disturbances such as hyperglycemia and hypercholesterolemia, which predisposes to pancreatitis.

[citation needed] There is an inherited form that results in the activation of trypsinogen within the pancreas, leading to autodigestion.

[30] Diagnosis requires 2 of the 3 following criteria:[citation needed] Amylase and lipase are 2 enzymes produced by the pancreas.

Elevations in lipase are generally considered a better indicator for pancreatitis as it has greater specificity and has a longer half life.

Additional tests that may be useful in evaluating chronic pancreatitis include hemoglobin A1C, immunoglobulin G4, rheumatoid factor, and anti-nuclear antibody.

[30] A contrast-enhanced CT scan is usually performed more than 48 hours after the onset of pain to evaluate for pancreatic necrosis and extrapancreatic fluid as well as predict the severity of the disease.

Patients with mild AP should still be hospitalized, at least briefly, to receive IV fluids and for clinical monitoring purposes.

Without blood supplying them, the pancreatic cells can become necrotic, resulting in tissue death that can become further worsened by the strong inflammatory response that occurs following necrosis.

Some species of gut bacteria are also known to detect pancreatitis and respond by releasing their own pro-inflammatory molecules.

Conversely, a healthy microbiome is beneficial for preventing infection, and several gut bacteria are known to augment human immune defenses and reduce systemic inflammation.

[37] The treatment of mild acute pancreatitis is successfully carried out by admission to a general hospital ward for fluid resuscitation and patient monitoring.

[8] Traditionally, people were not allowed to eat until the inflammation resolved but more recent evidence suggests early feeding is safe and improves outcomes and may result in an ability to leave the hospital sooner, and guidelines have been updated to recommend early feeding for patients able to tolerate it.

The drop in fluid levels can lead to a rapid and severe reduction in the volume of blood within the body, which is known as hypovolemic shock.

This condition represents a major life threat and may be prevented in some cases by prompt and aggressive fluid resuscitation.

[40] The lungs can be inflamed as a result of the systemic inflammatory response and can manifest as acute respiratory distress syndrome (ARDS).

The Modified Glasgow criteria suggests that a case be considered severe if at least three of the following are true:[45] This can be remembered using the mnemonic PANCREAS: The BISAP score (blood urea nitrogen level >25 mg/dL (8.9 mmol/L), impaired mental status, systemic inflammatory response syndrome, age over 60 years, pleural effusion) has been validated as similar to other prognostic scoring systems.

[9] In adults in the United Kingdom, the estimated average total direct and indirect costs of chronic pancreatitis is roughly £79,000 per person on an annual basis.