A 21yrs. old pt. attended a pay the previous night and gives the following symptoms - pain in abdomen radiating to back, pulse 100/min, BP 100/76 temp 39degC and vomiting before coming Most probable dx is :
Acute appendicitis
Acute cholecystitis
Acute diveiculitis
Acute pancreatitis
Ans. is "d' ie Acute Pancreatitis The signs and symptoms exhibited by the pt. correlate with that of acute pancreatitis, most characterstic of which is ---> Radiation of pain to back and pay in previous night (ie. h/o alcohol) Other imp. diagnostic clue (not given in question) is --> Relief from pain on sitting in upright posture.* Some imp. points about Acute Pancreatitis Etiology Gall stones (50 - 70% ie MC cause)* Alcohol (25%) Grey Turner sign or Cullens sign* : Bleeding into the fascial planes in acute pancreatitis can cause bluish discolouration of ? Umbilicus" v:shapes="_x0000_s1026">flanks* in Grey Turner sign* umblicus* in Cullens sign* Plain abdominal x-ray findings - include a - sentinel loop * - a colon cut off sign* - a renal 'halo' sign*