Question

A 58-year-old man presents with 2 hours of severe epigastric pain radiating to the back, associated with vomiting. He drinks heavily. Examination shows epigastric tenderness and guarding. Serum amylase and lipase are markedly elevated. What is the most appropriate initial management?

Accepted Answer

NPO (nil by mouth), aggressive intravenous fluid resuscitation, analgesia and hospital admission

Answer

Start clear oral fluids and discharge for outpatient follow-up

Answer

Immediate ERCP within 2 hours for all cases

Answer

Start prophylactic broad-spectrum antibiotics in all patients

Answer

Schedule elective cholecystectomy within 1 week without admission

Practice question

A 58-year-old man presents with 2 hours of severe epigastric pain radiating to the back, associated with vomiting. He drinks heavily. Examination shows epigastric tenderness and guarding. Serum amylase and lipase are markedly elevated. What is the most appropriate initial management?