A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase is three times the upper limit ...

Question

A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase is three times the upper limit of normal and lipase is elevated. Ultrasound shows no gallstones. What is the most appropriate initial management?

Accepted Answer

Aggressive intravenous fluid resuscitation, analgesia and monitoring on a surgical or high-dependency ward

Answer

Immediate ERCP

Answer

High-dose intravenous opioids only

Answer

Oral feeding as tolerated and discharge if pain improves

Answer

Start prophylactic antibiotics for all cases

uk-plab-1 MCQ (SBA): Acute pancreatitis

A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase is three times the upper limit of normal and lipase is elevated. Ultrasound shows no gallstones. What is the most appropriate initial management?