Clinical manifestations of acute pancreatitis: a narrative review of the literature
Keywords:
Abdominal pain; Pancreas; Acute pancreatitis; Acute abdomen syndrome; Clinical manifestationsAbstract
Introduction: Acute pancreatitis is a common condition that complicates the diagnostic and therapeutic process due to its clinical heterogeneity and potential for serious complications.
Objective: To critically analyze the most frequent clinical manifestations reported in the recent literature on acute pancreatitis.
Methods: A narrative review was conducted using a search in Spanish and English (December 2025) in PubMed, Scopus, SciELO, the Cochrane Library, and Google Scholar. Thirty-five articles (meta-analyses, clinical trials, clinical guidelines, and observational studies) published primarily within the last five years, with diagnoses based on the Atlanta criteria, were selected. The information was organized by thematic areas.
Results: Abdominal pain (97-100%), nausea (50-80%), and vomiting (71-80%) are the cardinal symptoms. Systemic inflammatory response syndrome (SIRS) is associated with a higher risk of severity (OR=1.99; 95% CI: 1.46-2.72). Jaundice (11–28%) is a strong predictor of biliary etiology. A palpable mass (<3%) suggests a pseudocyst or encapsulated necrosis. Cullen's and Grey-Turner's signs (<3%) indicate necrohemorrhagic forms and a poor prognosis. Persistent SIRS (>48 hours) and organ failure define severe pancreatitis.
Conclusions: Early recognition of abdominal pain, nausea, and vomiting, along with the identification of SIRS, jaundice, peritoneal reaction, or a palpable mass, allows for risk stratification, early initiation of multidisciplinary management, and a reduction in associated morbidity and mortality.
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