A 40-year-old man presents with severe epigastric pain radiating to the back after a large meal and alcohol intake. Serum lipase is markedly elevated,...

Question

A 40-year-old man presents with severe epigastric pain radiating to the back after a large meal and alcohol intake. Serum lipase is markedly elevated, and ultrasound shows gallstones but no bile duct dilatation. He is haemodynamically stable. What is the most appropriate initial management?

Accepted Answer

Nil per os, aggressive intravenous fluids, and analgesia

Answer

Immediate ERCP

Answer

Immediate laparoscopic cholecystectomy

Answer

Start prophylactic broad-spectrum antibiotics in all cases

Answer

Oral enzyme supplementation

ca-mccqe1 MCQ (SBA): Acute pancreatitis

A 40-year-old man presents with severe epigastric pain radiating to the back after a large meal and alcohol intake. Serum lipase is markedly elevated, and ultrasound shows gallstones but no bile duct dilatation. He is haemodynamically stable. What is the most appropriate initial management?