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Acute pancreatitis — RCPSC IM MCQ

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ModerateGastroenterology/HepatologyAcute pancreatitisRCPSC IM

A 52-year-old man presents with epigastric pain radiating to the back and vomiting. Lipase is 1800 U/L, ALT is 244 U/L, bilirubin is 38 umol/L, ultrasound shows gallstones without common bile duct dilation, and triglycerides are 1.8 mmol/L. He drinks minimal alcohol. What is the most likely diagnosis?

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Correct answer: D — Gallstone pancreatitis

Acute pancreatitis with gallstones and a markedly elevated ALT strongly suggests biliary pancreatitis from transient ampullary obstruction. Normal triglycerides and minimal alcohol use make other causes less likely.

Reference: Canadian Association of Gastroenterology acute pancreatitis guidance