Ruth is a 49-year-old office worker who presents to the clinic with a chief complaint of abdominal pain x 2 days
Ruth is a 49-year-old office worker who presents to the clinic with a chief complaint of abdominal pain x 2 days. The pain has significantly increased over the past 6 hours and is now accompanied by nausea and vomiting. The pain is described as “sharp and boring” in mid epigastrum and radiates to the back. Ruth admits to a long history of alcohol use, and often drinks up to a fifth of vodka every day.
Temp 102.2F, BP 90/60, respirations 22. Pulse Oximetry 92% on room air.
General: thin, pale white female in obvious pain and leaning forward. Moving around on exam table and unable to sit quietly.
CV-tachycardic. RRR without gallops, rubs, clicks or murmurs
Resp-decreased breath sounds in both bases with poor inspiratory effort
Abd- epigastric guarding with tenderness. No rebound tenderness. Negative Cullen’s and + Turner’s signs observed. Hypoactive bowel sounds x 2 upper quadrants, and no bowel sounds heard in both lower quadrants.
The APRN makes a tentative diagnosis of acute pancreatitis based on history and physical exam and has the patient transferred to the ER where laboratory and radiographic exams reveal acute pancreatitis.
Explain how pancreatitis develops and the role alcohol played in this patient’s case.