A 56-year-old man presents with sudden severe epigastric pain radiating to the back, following a weekend of heavy alcohol intake. Serum amylase and li...

Question

A 56-year-old man presents with sudden severe epigastric pain radiating to the back, following a weekend of heavy alcohol intake. Serum amylase and lipase are markedly elevated and ultrasound shows no gallstones. He is haemodynamically stable but in significant pain. What is the most appropriate initial management?

Accepted Answer

Nil by mouth, aggressive intravenous fluid resuscitation and opioid analgesia

Answer

Oral clear fluids and outpatient review

Answer

Immediate ERCP

Answer

Start broad-spectrum antibiotics for all cases

Answer

Immediate laparotomy to explore the abdomen

au-amc MCQ (SBA): Acute pancreatitis