Case 7: Summary

Diagnosis:  Mild Acute Gallstone Pancreatitis

Case Summary:

Acute epigastric abdominal pain has a broad differential that can include pathologies outside of the gastrointestinal system. Some of the most common GI diagnoses include pancreatitis, cholecystitis, choledocholithiasis, cholangitis, and peptic ulcer disease. For cases with suspected pancreatitis here a few key pearls for diagnosis and management:

Case authored by:  Alicia Philippou MD and Bhavana Bhagya Rao MD

References:

  1. 2013 ACG Acute Pancreatitis Guidelines:
    Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013 Sep;108(9):1400-15; 1416. doi: 10.1038/ajg.2013.218. Epub 2013 Jul 30. Erratum in: Am J Gastroenterol. 2014 Feb;109(2):302. PMID: 23896955.
  2. 2018 AGA Acute Pancreatitis Guidelines:
    Crockett SD, Wani S, Gardner TB, Falck-Ytter Y, Barkun AN; American Gastroenterological Association Institute Clinical Guidelines Committee. American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis. Gastroenterology. 2018 Mar;154(4):1096-1101. doi: 10.1053/j.gastro.2018.01.032. Epub 2018 Feb 3. PMID: 29409760.
  3. 2013 IAP/APA Acute Pancreatitis Guidelines:
    Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15. doi: 10.1016/j.pan.2013.07.063. PMID: 24054878.
  4. Gardner TB, Vege SS, Chari ST, Petersen BT, Topazian MD, Clain JE, Pearson RK, Levy MJ, Sarr MG. Faster rate of initial fluid resuscitation in severe acute pancreatitis diminishes in-hospital mortality. Pancreatology. 2009;9(6):770-6. doi: 10.1159/000210022. Epub 2010 Jan 21. PMID: 20110744.

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Case 7 Index:
Introduction
Physical Exam
Differential Diagnosis
Diagnostic Testing
Management
Hospital Course

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