Acute Pancreatitis - Symptoms and Signs

Symptoms and Signs

The most common symptoms and signs include:

• Severe epigastric pain radiating to the back
• Nausea, vomiting, diarrhea and loss of appetite
• Fever/chills
• Hemodynamic instability, which include shock
• Tachycardia
• Respiratory distress
• Peritonitis

Signs which are less common, and indicate severe disease, include:

• Grey-Turner's sign (hemorrhagic discoloration of the flanks)
• Cullen's sign (hemorrhagic discoloration of the umbilicus)
• Pleural effusions (fluid in the bases of the pleural cavity)
• Grünwald sign (appearance of ecchymosis, large bruise, around the umbilicus due to local toxic lesion of the vessels)
• Körte's sign (pain or resistance in the zone where the head of pancreas is located (in epigastrium, 6–7 cm above the umbilicus)
• Kamenchik's sign (pain with pressure under the xiphoid process)
• Mayo-Robson's sign (pain while pressing at the top of the angle lateral to the Erector spinae muscles and below the left 12th rib (left costovertebral angle (CVA))
• Mayo-Robson's point - a point on border of inner 2/3 with the external 1/3 of the line that represents the bisection of the left upper abdominal quadrant, where tenderness on pressure exists in disease of the pancreas. At this point the tail of pancreas is projected on the abdominal wall.

Other conditions to consider are:

• Pancreatic pseudocyst
• Pancreatic dysfunction (diabetes mellitus; malabsorption due to exocrine failure)
• Pancreatic cancer

Although these are common symptoms, they are not always present. Simple abdominal pain may be the sole symptom.