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23rd April 2024
A 46-year-old female presents to the Emergency Department with a 12-hour history of abdominal pain and vomiting
A 46-year-old female presents to the Emergency Department with a 12-hour history of abdominal pain and vomiting. She is afebrile in the department and there is no history of obvious infectious symptoms. Her past medical history includes laparoscopic appendectomy, high BMI and type 2 diabetes controlled on metformin. She confesses to drinking one glass of wine three times per week. On examination, she is very tender in her epigastric region and vomiting. She is slightly overweight.
Bloods show the following:
| Haemoglobin | 135g/l |
| White Cell Count | 12.1*10⁹/l |
| Neutrophils | 8.1*10⁹/l |
| Platelets | 347*10⁹/l |
| Sodium | 135 mmol/l |
| Potassium | 3.5 mmol/l |
| Urea | 5.0 mmol/l |
| Creatinine | 85 µmol/l |
| CRP | 40 mg/l |
| Amylase | 1200 U/L |
| Bilirubin | 21 µmol/l |
| Alkaline Phosphatase | 140 u/l |
| ALT | 40 u/l |
| AST | 35 u/l |
| Albumin | 35 g/l |
| HDL (Reference Range >1.2mmol/l for Females) | 1.1 mmol/l |
| LDL (Reference Range <3.0mmol/l for Females) | 3.4 mmol/l |
| Fasting Triglycerides (Target <1.7 mmol/l) | 1.8 mmol/l |
You suspect acute pancreatitis. What is the most likely cause in this scenario?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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