Following are included in criteria for diagnosing acute pancreatitis except
Correct Answer: Cullen sign
Description: DIAGNOSISAny severe acute pain in the abdomen or back should suggest the possibility of acute pancreatitis. The diagnosis is established by two of the following three criteria: (1) typical abdominal pain in the epigastrium that may radiate to the back, (2) threefold or greater elevation in serum lipase and/or amylase, and (3) confirmatory findings of acute pancreatitis on cross-sectional abdominal imaging.Patients also have associated nausea, emesis, fever, tachycardia, and abnormal findings on abdominal examination. Laboratory studies may reveal leukocytosis, hypocalcemia, and hyperglycemia.Computed tomography (CT) is the best imaging study for initial evaluation of a suspected pancreatic disorder and for the assessment of complications of acute and chronic pancreatitis. It is especially useful for the detection of pancreatic and peripancreatic acute fluid collections, fluid-containing lesions such as pseudocysts, walled-off necrosis, calcium deposits and pancreatic neoplasms. Acute pancreatitis is characterized by (1) enlargement of the pancreatic outline, (2) distoion of the pancreatic contour, and/or (3) a pancreatic fluid that has a different attenuation coefficient than normal pancreas.Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 370; Approach to the Patient with Pancreatic Disease; Page no: 2093
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