A 36-year old male presents to the clinic with symptoms of increasing abdominal pain that recently started radiating to his back, nausea and unintentional weight loss (20 pounds) over the past 4 months. He has recently been having oily diarrhea like stools. PMH includes HTN. Surgical Hx: None. Medications: HCTZ 25mg daily. Allergies: None. Family: Father deceased colon cancer at 70 years old, Mother living with HTN. Social: Smokes tobacco-1PPD for 35 years, admits to alcohol use daily- at least 2-3 beers every night for the past 10 years, and prior history of marijuana and IV drug use as a young adult. He is employed full-time as a supervisor at a local construction company. He is divorced and has 2 adult children. He does not exercise regularly.
Diagnostics: CBC, CMP, UA wnl. Abdominal ultrasound reveals enlarged pancreas with calcification.
After thorough evaluation the diagnosis Pancreatitis was made.
- Discuss Pancreatitis and 3 other differential diagnosis. Provide pertinent positives and negatives.
- What further history would you like to obtain to inform the diagnosis of pancreatitis? Provide rationale.
- What additional labs would you order?
- Discuss risk factors associated with Pancreatitis.
- Discuss clinical relevance of diagnostics revealed above and discuss additional diagnostics you would like to obtain to establish a diagnosis of pancreatitis?
- Consider likely stage of the pancreatitis as well as prognosis with and without appropriate treatment.
- Discuss management options of pancreatitis, along with rationale.