ObjectiveTo determine whether serum exosomal long non-coding RNA AC245100.4 has value for early diagnosis and prognostic stratification in acute pancreatitis (AP), and to examine its potential involvement in inflammation-related cellular communication.MethodsA total of 228 participants were enrolled during the early admission phase, including 152 patients with AP and 76 controls with non-pancreatic acute abdominal diseases. Serum samples were collected within the predefined early window (T0, wit