Pancreatitis

HISTORY:

‍Upper abdominal pain for ‍ ‍hoursdays

Onset: ‍gradualsudden, following ‍

Radiation: ‍noneback

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Type: ‍crampingburning

Pattern: ‍constantintermittent

Episode duration: ‍ ‍secminhoursdaysweeksmonths

Worsening factors: ‍noneeating

Alleviating factors: ‍nonefasting, ‍effectiveineffective

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍

‍hematemesis

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍dizziness

‍weight loss, ‍ ‍lbskg over ‍ ‍weeksmonths, ‍unintentionalintentional

‍jaundice

‍back pain



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍



ASSESSMENT:

‍Pancreatitis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍lytes, ‍creatinine, ‍LFTs, ‍lipase, ‍amylase, ‍lipid profile, ‍triglycerides, ‍calcium, ‍glucose, ‍CRP, ‍troponin, ‍ß-hCG

- Abdominal ultrasound

- CT scan of abdomen

- Chest X-ray

- MRCP

- ERCP

- ‍Dietary modificationsNPO

- IV fluids

- ‍Analgesics

- ‍Opioids

- ‍Anti-emetics

- ‍PPIs

- Reassess medications that may have caused pancreatitis (GLP-1, DPP-4)

- Light diet for the next days

- Referral to gastroenterologist

- Follow-up in ‍ ‍daysweeks

- Return if pain worsens, fever develops, jaundice appears, or if new symptoms develop such as vomiting or changes in stool color

- Go to ER if severe abdominal pain, severe vomiting, or fever occurs