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A 78-year-old man had fever, intermittent nausea and vomiting, and increasing abdominal pain for one week. He said he did not use alcohol. On examination, he had a distended abdomen and marked epigastric tenderness. His serum amylase and lipase levels were 1485 and 1608 U per liter, respectively. A contrast-enhanced computed tomographic (CT) scan of the abdomen showed a large amount of gas that severely distorted the pancreatic parenchyma (arrow) and a distended gallbladder with a 2-cm stone in its neck (arrowhead). The patient was treated with bowel rest, fluids, and imipenem. A CT scan one week later showed increasing . . . [Full Text of this Article] |
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