A 52-year-old woman presents to the urgent care center with several hours of worsening epigastric abdominal pain that radiates to the back. The patient also has malaise, chills, nausea, and vomiting. On physical exam, there is diffuse abdominal tenderness on palpation. She is afebrile. Other vital signs include a blood pressure of 126/74 mm Hg, heart rate of 74/min, and respiratory rate of 14/min. Her complete metabolic panel shows evelvated bilirubin levels of 2.7 and elevated lipase levels of 1,210. Given the following options, what is the most likely diagnosis?
Correct answer: Gallstone pancreatitis
General Feedback
Gallstone pancreatitis is caused by a gallstone that traverses the common bile duct and lodges at the major papilla (ampulla of Vater), thereby obstructing the flow of both bile and pancreatic enzymes. Patients can present with elevated total bilirubin, lipase, and serum amylase, as well as fever and leukocytosis.
Treatment is essentially the same as the management of acute pancreatitis, and elective cholecystectomy is recommended once the patient recovers. In the event that the patient starts to become septic, endoscopic retrograde cholangiopancreatography (ERCP) can be performed emergently to prevent progression to ascending cholangitis.
A 52-year-old woman presents to the urgent care center with several hours of worsening epigastric abdominal pain that radiates to the back. The patient also has malaise, chills, nausea, and vomiting. On physical exam, there is diffuse abdominal tenderness on palpation. She is afebrile. Other vital signs include a blood pressure of 126/74 mm Hg, heart rate of 74/min, and respiratory rate of 14/min. Her complete metabolic panel shows evelvated bilirubin levels of 2.7 and elevated lipase levels of 1,210. Given the following options, what is the most likely diagnosis?
Correct answer: Gallstone pancreatitis
General Feedback
Gallstone pancreatitis is caused by a gallstone that traverses the common bile duct and lodges at the major papilla (ampulla of Vater), thereby obstructing the flow of both bile and pancreatic enzymes. Patients can present with elevated total bilirubin, lipase, and serum amylase, as well as fever and leukocytosis.
Treatment is essentially the same as the management of acute pancreatitis, and elective cholecystectomy is recommended once the patient recovers. In the event that the patient starts to become septic, endoscopic retrograde cholangiopancreatography (ERCP) can be performed emergently to prevent progression to ascending cholangitis.