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- Title
Acute Pancreatitis with Abdominal Bloating and Normal Transabdominal Ultrasound.
- Authors
Dewi Halim, Silvikarina Erfanti
- Abstract
The diagnosis of acute pancreatitis (AP) is a topic of interest for clinicians, as it is an inflammatory disorder of the pancreas. A 44-year-old man presented with bloating for one month and it worsened one day before admission to the ER, accompanied by discomfort in the upper left abdomen. The patient had abdominal distension, but there was no vomiting or severe abdominal pain. The gallbladder had polyps on the ultrasound transabdominal, but there were no stones or pancreatitis. Magnetic resonance imaging (MRI) 2 months ago showed multiple stones in the gallbladder and normal pancreas. The laboratory results were leukocytes: 15x103/L, SGPT: 262, SGOT: 249, GGT: 1369 U/L, total bilirubin: 2.44, direct bilirubin: 2.08, lipase: 14,690 U/L, amylase: 3,693 U/L, and triglyceride: 56 mg/dl. The patient refused a CT scan or a repeated MRI. The levels of SGPT, SGOT, GGT, lipase, and amylase showed an improvement after 3 days. Based on the Atlanta classification, AP is diagnosed if at least 2 of the following 3 criteria are fulfilled: abdominal pain, serum lipase, or amylase at least 3 times the upper limit of normal (ULN) or characteristic findings on imaging. Gallstones are the most common cause of AP. Acute pancreatitis was suspected due to abdominal bloating that couldn't be explained by common causes, such as ascites, bowel edema, hematoma, and ileus. CT-scan contrast or MRI was necessary for patients who had normal USG and no classic sign of abdominal pain.
- Subjects
ATLANTA (Ga.); ABDOMINAL bloating; MAGNETIC resonance imaging; PANCREATITIS; ULTRASONIC imaging; COMPUTED tomography; NECROTIZING pancreatitis; CHRONIC pancreatitis
- Publication
Indonesian Journal of Gastroenterology, Hepatology & Digestive Endoscopy, 2023, Vol 24, Issue 3, p270
- ISSN
1411-4801
- Publication type
Case Study