Gallstone Pancreatitis Guidelines

Diagnosis and Risk Factors

The risk of gallstones is increased in patients with Crohn's Disease, according to the Journal of Crohn's and Colitis 1
Diagnosis of gallstone pancreatitis is based on at least two of three criteria: upper abdominal pain, elevated serum lipase/amylase, and consistent abdominal imaging, as recommended by the Journal of Crohn's and Colitis 1
Initial investigations should include pancreatic enzymes in plasma, liver function tests, and ultrasound of gallbladder, as suggested by Gut 2

Patients with severe gallstone pancreatitis should be managed in a high dependency unit or intensive care unit with full monitoring and systems support, according to Gut 3
Urgent therapeutic ERCP with sphincterotomy is indicated in cases with failure to improve within 48 hours despite intensive resuscitation, as recommended by Gut 3
Cholecystectomy should be delayed until signs of lung injury and systemic disturbance have resolved, as suggested by the guidelines 5

Prophylactic antibiotics, such as intravenous cefuroxime, may be considered in severe acute pancreatitis to prevent septic complications, according to Gut 3
In patients with inflammatory bowel disease, abdominal pain due to pancreatitis can be difficult to differentiate from that caused by active IBD, as noted by the Journal of Crohn's and Colitis 1
Asymptomatic elevated lipase is found in 7% of IBD patients, which can complicate diagnosis, as reported by the Journal of Crohn's and Colitis 1