What are the signs of acute pancreatitis (inflammation of the pancreas)?

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Last updated: February 28, 2025View editorial policy

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From the Guidelines

Acute pancreatitis is characterized by severe, persistent abdominal pain, nausea, vomiting, abdominal tenderness, and elevated pancreatic enzymes, and its diagnosis requires at least two of the following criteria: abdominal pain consistent with the disease, biochemical evidence of pancreatitis, and characteristic findings from abdominal imaging 1. The most common symptom is severe, persistent abdominal pain typically located in the upper abdomen and often radiating to the back. This pain usually develops suddenly and may worsen after eating. Nausea and vomiting frequently accompany the pain. Other signs include:

  • Abdominal tenderness when touched
  • Abdominal swelling or distension
  • Fever
  • Laboratory findings typically show elevated pancreatic enzymes (amylase and lipase) in the blood, which are released when the pancreas becomes inflamed
  • Some patients may develop jaundice (yellowing of the skin and eyes) if the bile duct becomes blocked
  • In severe cases, patients might experience hypotension (low blood pressure), tachycardia (rapid heart rate), and respiratory distress
  • Complications can include pancreatic necrosis, pseudocysts, or systemic inflammatory response syndrome Early recognition of these signs is crucial for prompt diagnosis and treatment, which typically involves hospitalization, pain management, fluid resuscitation, and addressing the underlying cause such as gallstones or alcohol consumption 1. The diagnosis of acute pancreatitis requires a combination of clinical evaluation, laboratory tests, and imaging studies, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) 1. It is essential to determine the etiology of acute pancreatitis on admission to project the need for definitive treatment and to avoid recurrence 1. The treatment and follow-up depend on the etiology of the acute pancreatitis, and a transabdominal ultrasound should be performed on admission to determine the etiology of the disease 1.

From the Research

Signs and Symptoms of Acute Pancreatitis

  • Abdominal pain radiating to the back 2, 3, 4, 5
  • Elevated serum amylase or lipase levels 2, 3, 4, 5
  • Characteristic findings on computed tomography (CT) scan or magnetic resonance imaging (MRI) 2, 3, 4, 5
  • Upper abdominal pain 3, 5
  • Nausea and vomiting 3

Diagnostic Criteria

  • Two out of three criteria must be met: abdominal pain, elevated lipase or amylase levels, and imaging findings of pancreatic inflammation 3, 4, 5
  • Serum lipase or amylase levels three or more times the upper limit of the normal level 4
  • Findings indicating pancreatitis obtained via CT scan or MRI 4

Common Etiologies

  • Gallstones 2, 3, 4, 5
  • Alcohol abuse 2, 3, 4, 5
  • Hypertriglyceridemia 4, 5
  • Obesity 4
  • Drugs 4, 5
  • Post-endoscope retrograde cholangiopancreatography (ERCP) 4
  • Autoimmune disorders 4
  • Smoking 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Critical care of the patient with acute pancreatitis.

Anaesthesia and intensive care, 2009

Research

Acute Pancreatitis: Updates for Emergency Clinicians.

The Journal of emergency medicine, 2018

Research

Diagnosis and Management of Acute Pancreatitis.

Diagnostics (Basel, Switzerland), 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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