In acute pancreatitis, the overflowing pancreatic juice contains a large amount of pancreatic enzymes that spread along the tissue interstitial space and seep under the skin to dissolve the subcutaneous fat, causing the capillaries to rupture and bleed, and the skin around the umbilicus appears blue-purple called Cullen’s sign. How to check for cyanosis of the skin around the umbilicus? In addition to purple skin around the umbilicus and lateral abdominal wall, there can also be skin damage on the extremities in the form of purple spots, blisters and necrosis, and skin damage is one of the signs of critical condition. The abdominal wall manifestations of acute pancreatitis are part of the systemic disease, and signs and symptoms such as abdominal wall edema, pressure pain and skin color change can be seen clinically. Most acute pancreatitis has a sudden onset and manifests as severe epigastric pain that radiates to the back of the shoulder, and the patient feels a girdling sensation in the upper abdomen and lower back. The location of abdominal pain is related to the location of the lesion, for example, if the lesion in the head of the pancreas is heavy, the abdominal pain is mainly in the right upper abdomen and radiates to the right shoulder; if the lesion is in the tail of the pancreas, the abdominal pain is heavy in the left upper abdomen and radiates to the left shoulder. The intensity of pain is consistent with the extent of the lesion. If it is edematous pancreatitis, the abdominal pain is persistent with paroxysmal aggravation and can be relieved by acupuncture or injection of antispasmodic drugs; if it is hemorrhagic pancreatitis, the abdominal pain is very intense, often accompanied by shock, and it is difficult to stop the pain by using general pain relief methods. The diagnosis of acute pancreatitis is mainly based on clinical manifestations, relevant laboratory tests and imaging examinations, which are clinically required not only to make the diagnosis of pancreatitis, but also to evaluate its development, complications and prognosis. Any patient with epigastric pain should be thought of as having the possibility of acute pancreatitis. This article is a prerequisite for the diagnosis of acute pancreatitis. It is more likely to be pancreatitis, especially in those epigastric pain whose diagnosis is not yet clear or when it is not relieved by the administration of antispasmodic analgesics. The diagnosis of this disease should have the following four criteria: (1) typical clinical manifestations, such as epigastric pain or nausea and vomiting, accompanied by epigastric pressure pain or signs of peritoneal irritation; (2) increased levels of pancreatic enzymes in serum, urine or abdominal puncture fluid; (3) image examination (ultrasound, CT) showing pancreatic inflammation or surgical findings or autopsy pathology confirming pancreatitis lesions; (4) the ability to exclude other lesions with similar clinical manifestations.