A 45-year-old man presents with sudden-onset severe epigastric pain radiating to the back after a binge of alcohol. Serum lipase is more than three ti...

Question

A 45-year-old man presents with sudden-onset severe epigastric pain radiating to the back after a binge of alcohol. Serum lipase is more than three times the upper limit of normal. Ultrasound shows no gallstones. He is haemodynamically stable. What is the most appropriate initial management strategy?

Accepted Answer

Aggressive IV fluid resuscitation, analgesia and early oral intake as tolerated

Answer

Immediate ERCP with sphincterotomy

Answer

Routine prophylactic broad-spectrum antibiotics

Answer

Nil per os and total parenteral nutrition from admission

Answer

Urgent laparoscopic cholecystectomy

ca-mccqe1 MCQ (SBA): Acute pancreatitis