Case presentation A 50-year-old man was presented in the ED with vomiting and severe epigastric pain radiating through the back. The pain had aggravated in the last two days. He denies such previous episodes. He is not taking any medicines but admits that he is a heavy smoker and drinks alcohol almost every day. Examination The patient looked sweaty and agitated. He could not lie flat on his stomach for examination and continued vomiting.
Blood pressure: 150/80 mmHg; Pulse rate: 120/min. Palpation in the abdomen reveals tenderness in the epigastrum. However, the abdomen is not distended and has normal bowel sounds. Complete blood analysis and electrolytes were unremarkable. Amylase: 4672 IU/dL (Normal range: 0-100 IU/dL); AST: 30 IU/dL (Normal range: 5-35 IU/dL); CGT: 212 IU/dl (Normal range: 11-51 IU/dL); Albumin, bilirubin, glucose, lactate dehydrogenase, and total serum calcium were…
