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Pizza, beer, amylase, lipase and the acute abdomen
  1. James A Catton,
  2. Dileep N Lobo
  1. Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
  1. Correspondence to Mr D.N. Lobo, Division of Gastrointestinal Surgery, E Floor, West Block, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK; dileep.lobo{at}nottingham.ac.uk

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Clinical presentation

A previously healthy 16-year-old male student was admitted with acute abdominal pain after eating two large pizzas and drinking five pints (approximately 2.8 l) of beer (alcohol content 4.5%). Initial assessment revealed epigastric tenderness with elevated serum amylase (380 IU/l, normal 30–110 IU/l) and lipase (4398 IU/l, normal 23–300 IU/l) concentrations. There was no free gas on the chest radiograph. The patient developed increasing abdominal pain, tenderness, tachycardia and a lactic acidosis (pH 7.20, lactate 2.91 mmol/l) within 6 h. Contrast-enhanced abdominal CT (figure 1) was done 8 h after admission.

Figure 1

Contrast-enhanced …

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