Acute Pancreatitis

A 38-year-old woman with a history of recurrent acute pancreatitis is admitted with severe epigastric pain, nausea, and vomiting. Laboratory investigations show: serum amylase 950 U/L, lipase 1800 U/L, serum calcium 7.2 mg/dL (normal 8.5–10.5), albumin 3.1 g/dL, and AST 180 U/L. Abdominal CT shows pancreatic edema without necrosis. Gallbladder ultrasound is normal. Genetic testing for CFTR mutations is positive. What is the most appropriate next step in management after initial supportive care?

A 42-year-old man with a history of gallstones presents with acute onset epigastric pain, nausea, and vomiting. Serum amylase is elevated at 800 U/L. Abdominal ultrasound confirms acute pancreatitis secondary to choledocholithiasis. After initial fluid resuscitation and supportive care, which antibiotic is the drug of choice for prophylaxis in this patient with predicted severe acute pancreatitis (APACHE score 8)?

A 38-year-old woman with acute alcoholic pancreatitis presents with severe epigastric pain, elevated amylase (1200 U/L), and signs of systemic inflammatory response. She is fluid-resuscitated and hemodynamically stable. Which drug is the first-line choice for analgesia in acute pancreatitis?

A 38-year-old woman presents to the emergency department with acute onset epigastric pain radiating to the back, associated with nausea and vomiting for 6 hours. She has a history of gallstones. On examination, she is febrile (38.5°C) with epigastric tenderness. Serum amylase is elevated at 450 U/L (normal <100). What is the investigation of choice to confirm acute pancreatitis and assess severity?

A 52-year-old man with chronic alcohol use presents with acute epigastric pain and elevated serum amylase (320 U/L). Clinical examination and basic biochemistry suggest acute pancreatitis. He is hemodynamically stable with no signs of organ failure. What is the most appropriate next investigation to identify the etiology and guide management?