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Calcium
46%
145/313
Glucose
9%
29/313
Amylase
8%
26/313
Lipase
21%
67/313
Triglycerides
13%
42/313
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The patient is hospitalized 1 day post-ERCP with symptoms and imaging suggestive of acute pancreatitis. In acute pancreatitis, serum amylase levels are elevated and free digested fats may bind with serum calcium, causing hypocalcemia. ERCP is the third most common cause of acute pancreatitis, following alcohol ingestion and gallstones. Acute pancreatitis symptoms include nausea/vomiting, severe epigastric pain, weakness, low fever, shock, and tetany due to hypocalcemia. Physical exam findings include abdominal tenderness, diminished bowel sounds, and jaundice (rare). Treatment includes pain control and acute management (IV fluids, bowel rest, NG decompression, antibiotics, and oxygen). Illustration A shows an axial CT of acute pancreatitis. Extensive fluid collections surround the pancreas. Incorrect Answers: Answers 2-4: Serum levels of glucose, amylase, and lipase would be expected to increase in acute pancreatitis. Answer 5: Hypertriglyceridemia can cause acute pancreatitis.
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