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Pancreatitis – Information for GPs

Referral criteria / commissioning position

Any patient with suspected acute pancreatitis should be admitted to secondary care.

Refer to secondary care for:

  • severe, continuous and boring pain. Sudden in onset in epigastrium or with generalised peritonism
  • pain may radiate to the RUQ, chest, flanks and other abdomen
  • nausea and vomiting common
  • fever common
  • distension due to increased fluid in retroperitoneum pushing small bowel with fluid filled loops of a small bowel ileus
  • a late and serious sign is blueish discolouration around the umbilicus (Cullen’s sign) or the flank (Grey-Turners’ sign)
  • hypotension and tachycardia secondary to hypovolaemic shock

Investigations prior to referral (do not delay 2 week referral for these)

In the acute setting none, if chronic then bloods and USS if gallstones have been suspected

Information to include in referral letter

  • If a more chronic picture then alcohol intake and any previous USS results suggesting the presence of gallstones. If bloods performed then include CRP, amylase and LFTs
  • History, treatments and interventions tried in primary care including the results
  • Relevant past medical/surgical history
  • Drug history (prescribed and non-prescribed)
  • Current regular medication
  • BMI
  • Smoking status
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