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Severe acute pancreatitis with organ dysfunction — RCPSC EM MCQ

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HardGI/Abdominal emergenciesSevere acute pancreatitis with organ dysfunctionRCPSC EM

CTAS 2: A 52-year-old with heavy alcohol use has epigastric pain radiating to the back. Vitals are BP 92/58, HR 124, RR 28, SpO2 92%. Lipase is 1400 U/L, creatinine is 198 µmol/L, lactate is 4.1 mmol/L and CT shows peripancreatic inflammation without necrosis. What is the most appropriate disposition?

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Correct answer: E — Admit to ICU or high-acuity monitored care

Pancreatitis with shock physiology, renal injury, hypoxia or high lactate requires aggressive resuscitation and monitored admission, even if necrosis is absent early.

Reference: Canadian surgical and critical care practice; Atlanta pancreatitis classification