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Case 1: Complications of pancreatitis: hyperbilirubinemia

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A 49 year old male presents to the ed with c/o epigastric pain radiating to his back. Patient states that pain started 3 days ago and has been radiating to the back. Patient states eating or drinking makes pain worse and he has had no appetite for days. Patient c/o nausea, vomiting. Patient denies any fever, chills, diarrhea., chest pain, or shortness of breath. Patient states he is a chronic alcoholic and drinks 12 packs of alcohol daily. PMHx: chronic pancreatitis. Pt smoke 1 1/2 packs a day.
BILI, TOTAL 5.07 H mg/dL Normal 0.20-1.00
PROTEIN, TOTAL 7.1 g/dL Normal6.4-8.2
ALK PHOSPHATASE 592 H U/L Normal 50-136
ALT (SGPT) 144 H U/L Normal 6-78
AST(SGOT) 57 H U/L Normal 0-45
BILI, DIRECT 3.96 H mg/dL Normal 0.00-0.20
ALBUMIN 1.8 L g/dL Normal 3.5-5.0

Take home lesson
Patient with pancreatitis has many complications such as pseudocyst formation, pancreatic abscess, necrosis, sepsis. Patient will require percutenous drainage of the pseudocyst.

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