ROSH Gastrointestinal Practice Exam

Which of the following is an appropriate therapy for a patient with severe acute pancreatitis?

1. Antibiotics

2. Anticholinergic agents

3. Calcium chloride

4. Crystalloid infusion

The correct answer is: Crystalloid infusion

In the management of severe acute pancreatitis, crystalloid infusion plays a crucial role. This therapy is vital for addressing volume depletion due to the inflammatory process that occurs in the pancreas, which can lead to significant fluid loss into the abdominal cavity and extracellular space. Administering crystalloid solutions, typically normal saline or lactated Ringer's solution, helps to restore intravascular volume, maintain renal perfusion, and improve overall hydration status. Beyond just fluid resuscitation, correct hydration is essential in preventing complications, such as acute kidney injury, which can arise from hypovolemia. The objective is to ensure the patient remains euvolemic and to stabilize hemodynamics, promoting recovery and mitigating further pancreatic injury. While antibiotics and other choices may have their roles in specific circumstances, they are not foundational therapies for severe acute pancreatitis. Antibiotics are generally reserved for cases with infection or infection risk, anticholinergic agents do not address the underlying process or fluid management, and calcium chloride does not have a direct or effective application in acute pancreatitis treatment. Thus, crystalloid infusion stands out as the essential and appropriate therapy in this clinical scenario.