Acute Pancreatitis, # 16
Gold-standard vignette
Chief complaints
Abdominal pain
History of presenting illness
He presented with severe mid-epigastric abdominal pain that radiates to the back for three days. The pain improves when the patient leans forwards or assumes the fetal position, and worsens with deep inspiration and movement.
He also complains of nausea, vomiting, and anorexia, and gives a history of heavy alcoholic intake this past week.
He is slightly agitated and confused. He is diaphoretic.
Absent findings
No acid reflux, No diarrhea or constipation, No chest pain or discomfort, No abdominal tenderness, No urinary symptoms, No melena, No recent weight loss, No smoking history.
Physical examination
He is tachypneic, tachycardic and febrile.
Past medical & surgical history
None
Differential diagnosis
1 - Acute pancreatitis
2 - Acute cholecystitis
3 - Gastritis
4 - Peptic ulcer disease
5 - Chronic pancreatitis