Clinical management of Acute Pancreatitis in Uganda
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Clinical Features
Acute abdominal pain in epigastrium radiating to the back. Worsened by eating/lying down, relieved by sitting/leaning forward. Nausea, vomiting, abdominal distension. Fever, tachycardia, dehydration. Very tender abdomen.
Investigations
Raised pancreatic amylase and lipase >3 times normal. Serum analysis, CBC, RBS. Ultrasound (gallstones, oedema). LFTs.
Treatment
General Management
Fluid resuscitation: 2-3 Litres of IV crystalloids (Ringer’s lactate/Normal saline) within first 24 hours. Monitor vital signs and urine output. Fasting until pain resolves.
Pain Management
Analgesia (Pethidine/Morphine). Nutritional support (enteral/parenteral if oral not tolerated).
Glycaemic Control
Keep blood sugar between 6-9 mmol/L. Avoid hypoglycaemia. Look out for diabetes mellitus.
Severe Acute Pancreatitis
Persistent organ failure (>48 hrs). Refer to specialist. HDU/ICU monitoring. Aggressive volume resuscitation, mechanical ventilation if needed, renal replacement.
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