26th April 2024

A 49-year-old woman presents to the emergency department with a 48-hour history of severe, constant epigastric pain radiating to her back.

A 49-year-old woman presents to the emergency department with a 48-hour history of severe, constant epigastric pain radiating to her back. She describes the pain as 8 out of 10 in intensity and worsening. She also reports nausea and two episodes of vomiting. She has a history of hyperlipidemia and occasional alcohol use. On examination, her abdomen is distended and tender in the epigastric region. Her vital signs show a heart rate of 95 bpm, blood pressure of 125/80 mmHg, and a temperature of 38.1°C.

Investigations:

Serum amylase: Significantly elevated

Abdominal CT scan: Peripancreatic fat stranding

Lipid profile: Elevated triglycerides

Which is the most likely diagnosis?