With the increasing incidence and prevalence of inflammatory bowel diseases (IBD), its complications and associated morbidity also continue to rise. One of these is non-cirrhotic portal hypertension. There is an increasing need of recognizing and understanding the pathophysiology of this condition in the clinical setting of IBD, especially in long standing cases. Due to multiple potential factors, patients with IBD appear to be at a higher risk of developing portal hypertension even in the absence of liver cirrhosis. Portal hypertension is usually diagnosed when complications (such as ascites, variceal bleeding) develop, especially when patients have already experienced multiple complications of the disease. Hence, a high level of vigilance for the detection of portal hypertension at an early stage is needed. This review discusses the known epidemiology, clinical characteristics, clinical presentation, modalities of diagnosis and the potential treatments of the different forms of non-cirrhotic portal hypertension associated with IBD. The concomitant presence of portal hypertension can significantly impact the overall clinical picture and disease burden in IBD. Hence, increased awareness of this condition at an early stage might help tailor a comprehensive and individualized therapeutic plan of care for these patients.

Improvement in diagnostic and therapeutic techniques has led to revision of past guidelines on the management of acute pancreatitis (AP), still not uniformly applied on the territory, partly due to the different distribution of resources to the various centers, partly due to the lack of unequivocal conduct in the approach itself. We had tried to outline most important changes emerged from the revision of recent and authoritative guidelines, focusing on what we believe are still critical points and identifying attitudes more equally shared than others. Based also on the experience of our small center, which however manages numerous cases of AP and their complications, we finally proposed a simple decision algorithm, which does not claim to be a codified recommendation, but only a small and concrete suggestion.