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Acute pancreatitis with early organ dysfunction — SCE Acute Medicine MCQ

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ModerateGastroenterology and hepatologyAcute pancreatitis with early organ dysfunctionSCE Acute Medicine

A 57-year-old man presents with severe epigastric pain radiating to the back and vomiting. Lipase is 1,840 IU/L and CRP is 76 mg/L on admission. He is tachycardic, oxygen saturations are 94% on 2 L/min and creatinine is 172 micromol/L. Ultrasound is pending. What is the most appropriate next step in management?

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Correct answer: E — Admit, give aggressive supportive care with IV fluids, analgesia and early severity reassessment

Acute pancreatitis is managed initially with supportive care, adequate fluids, analgesia and monitoring for organ dysfunction. Antibiotics are not used prophylactically, and ERCP is reserved for cholangitis or persistent biliary obstruction. Early severity reassessment is important because renal impairment and oxygen need suggest potentially severe disease.

Reference: NICE NG104