Acute Pancreatitis: Nothing to SPiT At

Excerpt

An 18-year-old female patient was initially evaluated for a 3-day history of worsening epigastric pain, nausea, and vomiting. She had no known medical problems and no history of alcohol consumption, cigarette smoking, or marijuana use. Her only medication was levonorgesterol/ethinyl estradiol for birth control. Physical examination revealed blood pressure 110/65 mmHg, pulse 91/min, temperature 36.6 °C, and respiratory rate 16/min. Cardiopulmonary examination showed normal heart sounds and clear breath sounds. Abdominal examination revealed a flat abdomen with normal bowel sounds, dullness on percussion all over the abdomen, and tenderness on palpation of the epigastrium with local guarding but no rebound tenderness. Murphy’s and Carnett’s signs were negative. Complete blood count, metabolic panel, and liver function laboratory testing were normal with the exception of an elevated serum lipase (8369 U/L; normal range 12–70 U/L). …