Chronic alcoholic with "acute abdomen"

A 40-year old male, obese, chronic alcoholic was admitted to TJU Hospital with a diagnosis of "acute abdomen". Severe pain and tenderness started after a large meal, which included a considerable amount of alcohol. The pain radiated over the entire abdomen into the back.

Physical examination revealed a pulse rate of 120/minute. The blood pressure was 90/50 mm Hg. He was wheezing, in apparent respiratory distress, and extremely apprehensive. The anterior abdominal wall was rigid and very tender to palpation.

Laboratory findings included increased amylase and lipase in the serum. The following day, low serum calcium and glucosuria were found. The patient was treated for shock, but this was unsuccessful. The patient died on the third day of hospitalization.

The correct answer is C. Acute pancreatitis. There were a total of 13 responses. A breakdown of responses are inside the parentheses below.

The most likely diagnosis is:

A. Alcoholic liver disease (1)
B. Bleeding esophageal varices (0)
C. Acute pancreatitis (12)
D. Cholestatic jaundice (0)
E. Acute viral hepatitis (0)

(see results graphically)