Jake Merkel

A 43-year-old man presents to the emergency department with severe upper abdominal pain radiating to his back, eased by leaning forward, with nausea and vomiting. He has a long history of heavy alcohol use. Take a focused history, perform a relevant examination, and initiate appropriate management.

1. 1Take a focused history of the abdominal pain including SOCRATES
2. 2Take a detailed alcohol history
3. 3Explore associated symptoms and past medical history including gallstones and previous pancreatitis
4. 4Verbalise a focused abdominal examination
5. 5Order and justify appropriate investigations (amylase, lipase, imaging)
6. 6Provide a working diagnosis with severity assessment
7. 7Initiate acute pancreatitis management including IV fluids, analgesia and admission
8. 8Discuss lifestyle modification and arrange follow-up