Clinical manifestations-acute pancreatitis

• Epigastric abdominal or LUQ pain (90%), only ½ w/ bandlike pain radiating to back

• 10% pain-free (due to analgesic/steroid use, immunosuppressed, ΔMS, ICU); ∴ ✓ lipase in unexplained shock, periumbilical or flank (Cullen or Grey Turner signs) bruising

• N/V (90%), abd tenderness/guarding, ↓ bowel sounds, jaundice if biliary obstruction

• Ddx: acute cholecystitis, perforated viscus, SBO, mesenteric ischemia, IMI, AAA leak, distal aortic dissection, ruptured ectopic pregnancy

• Early phase (<1 wk): possible SIRS ± organ failure; late (>1 wk): local complications (qv)