ABSTRACT
This chapter presents a case study of a 55-year-old woman who is admitted to the Emergency Department with a 2-day history of worsening right upper quadrant and epigastric pain that sometimes moves around to her back. The pain is now constant and is not relieved by paracetamol or ibuprofen. She has been feeling nauseous and has vomited on a few occasions. She has a history of diet-controlled type 2 diabetes and hypertension. She does not smoke and denies significant alcohol intake. The differential diagnosis of right upper quadrant and epigastric pain includes conditions affecting the upper GI tract, namely the oesophagus, stomach, duodenum and pancreas. Confirmation of the diagnosis requires at least two of the following: characteristic acute epigastric pain radiating to the back, elevated pancreatic enzymes and typical findings on imaging (usually CT). There are three main facets that form the basis of the initial management of acute pancreatitis: fluid repletion, pain control and nutrition.
