skip to main content

Acute pancreatitis severity assessment — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute GI PresentationsAcute pancreatitis severity assessmentSCE Acute Medicine

A 47-year-old woman presents with epigastric pain radiating to the back and vomiting. Lipase is 1,200 U/L and ultrasound shows gallstones without bile duct dilatation. After 24 hours she remains tachycardic with oxygen saturation 92% on air, CRP 230 mg/L and creatinine 164 micromol/L. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Escalate to high-dependency care and monitor for organ failure

Persistent organ dysfunction markers and high inflammatory response suggest severe pancreatitis needing close monitoring and escalation. Prophylactic antibiotics are not indicated for sterile pancreatitis. ERCP is reserved for cholangitis or persistent biliary obstruction. The pearl is that early severity is driven by organ failure rather than the lipase number.

Reference: NICE NG104; BSG pancreatitis guidance