Pizza, beer, amylase, lipase and the acute abdomen
- Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
- 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
- Published Online First 10 June 2010
- Acute gastric dilatation
- perforation
- acute pancreatitis
- lipase
- amylase
- ischaemia
- abdominal pain
- alcohol
- gastric surgery
- pancreatic enzymes
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. …
