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Acute Pancreatitis?

I am currently a medical student and was presented with the following case. I have thought of a primary diagnosis and would appreciate any input greatly! Thank you so much for your time!

A 66-year-old man is admitted with complaints of progressively severe constant upper abdominal pain, nausea, and vomiting of 48 hours duration. Recently, he has consumed large quantities of vodka, but has no history of biliary tract disease and is taking no medication.
He is a thin man, who is found wincing and clutching his abdomen.
His temperature is 38O C
Blood pressure 100/60 mmHg
Pulse 90 beats per minute
Respirations 19 per minute
His abdomen is flat and the bowel sounds are hypoactive.
There is marked tenderness with guarding in the midepigastrium, but no peritoneal signs.

I suspect ACUTE PANCREATITIS based on both the symptoms and the physical examination. To test this I would check his serum for amylase. Does that sound right?
1 Responses
701334 tn?1262857103
id say check the amylase/lipase...usualy best while in pain,,,not after it subsides.
ultra sound of the pancreas.
does he have pain through to his back?
epigastric pain mostly center to left side?
is his belly destended?

barrium swallow could rule out ulcer do to years of alcohol abuse,and to be sure hes not got excessive stomach bleeding.,,
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