Acute onset Pain Abdomen

A young male aged 34 years Chief Complaints Pain Abdomen (Acute onset) [Epigastric, radiating to back] Vomiting (Multiple Episodes) (x 2 days) Physical Examination P/A - Tenderness, BS (sluggish)

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Is pt alcoholic? Or diagnosed with GB stone? Any h/o trauma? It may acute pancreatitis Kindly adv s lipase,s amylase

History in favor of Pancreatitis Do ldh serum amylase Ascitic fluid Tapping Cbnat Rx after report Opinion of gastroenterologist

Cect images are not clear, but history is suggestive of- Acute pancreatitis Perforated peptic ulcer ( less likely, due to absence of free air intraperitonially on CT) Diagnosis- Xray abdomen erect USG hepatobiliary n pancreatic system CECT - bulky pancreas, peripancreatic fat stranding, fluid ; CT severity scoring S. Lipase n amylase Ranson's scoring at presentation n 48 hrs later for prognostication ABG CBC RFT LFT Management: Keep NPO IVFluids NG placement on continuous aspiration Strict urine output monitoring Input out n vitals charting Broad spectrum antibiotics Antiemetics Analgesics Antacids Need for TPN

? acute pancreatitis images too small

Gastiratis,? constipation

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