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A 36-year-old man was referred to the hospital because of recurrent epigastric pain and persistently elevated amylase levels.
The patient had been well until five months earlier, when he began to have epigastric pain. At that time, the amylase level was 349 U per liter (normal, 25 to 115). The white-cell count and the results of tests of liver function were normal. The bouts of epigastric pain continued, and the amylase level did not return to normal. Radiographs of the abdomen showed no evidence of bowel obstruction or perforation. An abdominal ultrasonographic study revealed no gallstones. Computed tomographic (CT) scanning
Differential Diagnosis
Neoplastic Diseases
Inflammatory Diseases
Acute Pancreatitis
Drug-Induced Pancreatitis
Chronic Pancreatitis
Clinical Diagnosis
Dr. Carlos F. Fernández-del Castillo's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Departments of Surgery (C.F.F.-C.), Radiology (D.V.S.), and Pathology (G.Y.L.), Massachusetts General Hospital and Harvard Medical School.
Related Letters:
Case 27-2003: A 36-Year-Old Man with Recurrent Epigastric Pain and Elevated Amylase Levels
Lowenfels A. B., Makins R., Castillo C. F.-d.
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N Engl J Med 2003;
349:2171-2172, Nov 27, 2003.
Correspondence
This article has been cited by other articles:
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