Gastroenterology: pancreatitis, gallbladder disease
General Medicine · MBBS
Study notes
Severe epigastric pain boring to the back after a fatty meal — gallstone pancreatitis; lipase confirms. Acute pancreatitis (epigastric pain → back, vomiting + amylase/lipase >3×; causes — gallstones, alcohol — I GET SMASHED): severity — organ failure/necrosis (CT); treat — aggressive IV fluids, analgesia, early nutrition, ICU if severe; gallstone — cholecystectomy after recovery. Gallstones (4Fs — RUQ colic, Murphy's inspiratory arrest): cholecystitis (fever + Murphy's — antibiotics + laparoscopic cholecystectomy); CBD stone (jaundice + Charcot's — fever, jaundice, RUQ pain; Reynolds' adds shock — ERCP urgently). The back-boring pain is pancreatic — lipase proves it.
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