A 55 year old male presents with severe epigastric pain...

A 55-year-old male presents with severe epigastric pain radiating to the back, nausea, and vomiting. On physical examination, he appears pale and diaphoretic. Laboratory tests reveal elevated serum levels of amylase and lipase. Based on the clinical presentation, what is the most likely diagnosis? O Peptic ulcer disease O Acute pancreatitis O Gastric cancer O Cholecystitis

Transcript

00:01 In order to answer this question, let's talk about abdominal pain.

00:03 In this case, it says, a 40 -year -old woman with a history of hyperlipidemia.

00:09 So you have here, hyperlipidemia, presents to her primary care physician with an hour history of severe epigastric pain.

00:23 So you have severe epigastric pain.

00:31 It says that the body is to the back.

00:33 So it is, this data here, this information is very, very, very.

00:38 Important because just with this information you can or the first thing that you can think about is pancreatitis because that the characteristic of pain of abdominal pain in acute pancreatitis is epigastric pain it means pain in the like in the in the superior part of the abdomen and that pain radiates to the back okay like in a built pattern pain in a built pattern so in this in this case, it says that patient also complains of decreased appetite, nausea, and vomiting.

01:13 So that's also, those are also fetters of pancreatitis.

01:17 Then it says, vomiting small amounts of yellow, sour fluid.

01:23 Then it says, on physical exam, patient is jaundiced and tender to palpation in the epicastic region.

01:29 So you have here, the patient has jaundice.

01:33 And it says, laboratory results are as follows.

01:36 As you can see here amylase and also lipase that are two tests that that test in case or are increased in acute pancreatitis are very high.

01:53 Now it is, what is the most likely diagnosis here and the answer is acute pancreatitis? the most common cause of acute pancreatitis is gold blooded stones.

02:14 Stones.

02:16 Okay, as you may remember, here if you have your gold bladder, you're going to have the cystic duct and then the billiary or the common bile duct and then you're going to get to the duodenum and here you have your pancreas, something like this.

02:34 So if you have a goldstone in your goldbladder, then these gold stones can come here and follow this pathway and they can construct.

02:46 That this lumen of the pancreatic duct and it is going to cause inflammation of the panace...

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