65 yr old Male- CKD- V Planned for HD Now abd pain, vomiting/constipation Abdomen- Diffuse tenderness Bowel Sounds sluggish BP-170/90mmHg HR-72/min RR-22/min Interpret the diagnosis ?



Acute pancreatitis with ileus

dilated bowel loops


AXR- Dilated bowel loop without air fluid levels in LUQ s/o ileus Sentinel Loop Sign A sentinel loopis a focal area of adynamic ileus close to an intra-abdominal inflammatory process. May aid in localizing the source of inflammation Upper abdomen – pancreatitis Lower quadrant - appendicitis Lipase-10,000 CT: Pancreas diffusely enlarged with perpancreatic fluid. Acute pancreatitis

is dyselectrolytemia present????

Pancreatitis with ileus

acute pancreatitis with dyselectrolytemia

paralytic ileus verses subacute intestinal obsruction.

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