A 43-year-old woman with a history of alcohol excess presents with severe epigastric pain radiating to the back, vomiting and low-grade fever. Serum a...

Question

A 43-year-old woman with a history of alcohol excess presents with severe epigastric pain radiating to the back, vomiting and low-grade fever. Serum amylase is three times the upper limit of normal. Ultrasound shows gallstones. What is the most appropriate initial management?

Accepted Answer

Nil by mouth, aggressive intravenous fluid resuscitation and opioid analgesia

Answer

Oral analgesia and discharge with outpatient ultrasound

Answer

Immediate ERCP for stone removal

Answer

Start high-dose intravenous steroids

Answer

Immediate elective cholecystectomy under general anaesthesia

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

A 43-year-old woman with a history of alcohol excess presents with severe epigastric pain radiating to the back, vomiting and low-grade fever. Serum amylase is three times the upper limit of normal. Ultrasound shows gallstones. What is the most appropriate initial management?