The indications for early ERCP are:

Clinical deterioration or lack of improvement after 24 hours
Detection of common bile duct stones or dilated intrahepatic or extrahepatic ducts on abdominal CTThe risks of ERCP are that it may worsen pancreatitis, it may introduce an infection to otherwise sterile pancreatitis, and bleeding. Surgery
Surgery is indicated for (i) infected pancreatic necrosis and (ii) diagnostic uncertainty and (iii) complications. The most common cause of death in acute pancreatitis is secondary infection. Infection is diagnosed based on 2 criteria

Gas bubbles on CT scan (present in 20 to 50% of infected necrosis)
Positive bacterial culture on FNA (fine needle aspiration, usually CT or US guided) of the pancreas.Surgical options for infected necrosis include:

Minimally invasive management – necrosectomy through small incision in skin (left flank) or abdomen
Conventional management – necrosectomy with simple drainage
Closed management – necrosectomy with closed continuous postoperative lavage
Open management – necrosectomy with planned staged reoperations at definite intervals (up to 20+ reoperations in some cases)

Other measures
Pancreatic enzyme inhibitors are proven not to work. The use of octreotide has been shown not to improve outcomes. Classification by severity: prognostic scoring systems
Acute pancreatitis patients recover in majority of cases. Some may develop abscess, pseudocyst or duodenal obstruction. In 5 percent cases, it may result in ARDS (acute respiratory distress syndrome), DIC (disseminated intravascular coagulation)
Acute pancreatitis can be further divided into mild and severe pancreatitis. Mostly the Ranson Criteria are used to determine severity of acute pancreatitis. In severe pancreatitis serious amounts of necrosis determine the further clinical outcome.
Chondrodermatitis nodularis chronica helicis is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, most often in men. : 610  it often presents as a benign painful erythematous nodule fixed to the cartilage of the helix or antihelix of the external ear. Although the exact cause of the condition is unknown, it has been linked to head pressure on the ear while sleeping. Treatment options include the use of pressure-relieving devices or, in cases where that is not an option, surgery. See also
List of cutaneous conditions


== References ==