A chronic alcoholic patient came to emergency with severe pain in epigastrium and multiple episodes of vomiting. On examination, guarding was present in upper epigastrium. Chest X-ray was normal. What is the next best step?
Correct Answer: Serum lipase
Description: From the given case: ACUTE PANCREATITIS- Chronic Alcoholic- Severe pain in Epigastrium- Episodes of vomiting* Normal CXR- Perforation peritonitis is ruled out - no pneumoperitoneum Acute Pancreatitis: Etiology Clinical Presentation Gall stones Pain in Epigastrium- radiating to left back Alcoholism Ileus- Nausea & Vomiting Trauma to Abdomen Tachypnea Ampullary tumor Abdominal distention Drugs Guarding +nt Hyperparathyroidism Hypotension maybe +nt. Hypercalcemia Pancreatic divisum Viral infections Scorpion bite Malnutrition Idiopathic INVESTIGATIONS:Initial investigation:- Clinical findings- Amylase - Not specific- Lipase - Specific (preferred) Imaging: - CECT - IOC + Staging investigation.- Balthazar criteria- To be performed after 72 hours as pancreatic necrosis is evident 1st 24 hrs.- Upper GIE & Alcohol breath test - Not done as the patient is alcoholic- No history of upper GI bleeding
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now