Editor's quiz: GI snapshot
A puzzling presentation of pancreatitis
1 Unit for Liver, Biliary and Pancreatic Diseases, Catholic University of Leuven, Leuven, Belgium
2 Department of Radiology, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium
3 Hepatobiliary and Transplant Surgery, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium
Correspondence to:
Dr W Laleman, Unit for Liver, Biliary and Pancreatic Diseases, Catholic University of Leuven, Leuven, Belgium; Wim.Laleman@uz.kuleuven.ac.be
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
An 80-year old lady was admitted to the emergency department because of acute dyspnoea and orthopnoea. She reported no chest pain. Her previous medical history showed compensated congestive heart failure and a cholecystectomy for calculous cholecystitis. Clinical examination revealed absent breath sounds at the left lung base without further abnormalities. Her chest x ray is shown in fig 1. She was admitted to the Department of Cardiology for further investigations, including spiral chest CT for the exclusion of pulmonary thromboembolism (
figs 2 and 3). Within 24 h after admission, she developed fever, vomiting and epigastric pain. Laboratory work-up revealed abnormal liver tests (aspartate aminotransferase (AST) and alanine aminotransferase (ALT) 4–5x upper limit of normal (ULN), 
-glutamyltranspeptidase (GGT) 20x ULN, alkaline phosphatase 3x ULN, bilirubin normal) as well as increased amylase and lipase levels (7x ULN and 40x ULN, respectively). Ultrasound showed no
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Gut 2008 57: 1287.[Extract] [Full Text] [PDF]
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