acute pancreatitis



39 year old male, farmer by occupation, came to hospital with C/O Pain Abdomen,  nausea and vomiting from last 6 days

HOPI:
Patient was apparently asymptomatic 6 days ago, and then he developed pain abdomen- intermittent, throbbing type of pain, initially in epigastric region and later progressed to diffuse type , associated with vomitings-1 episode, non bilious, non projectile, food as the content.
- Pain Abdomen increases after food/water intake
- Fever: low grade, intermittent, not associated with chills and rigors, burning micturition, headache, neck pains, relieved with medication.

PAST HISTORY: Not a K/C/O HTN/DM/BA/Epilepsy

PERSONAL HISTORY:
Diet- mixed
Appetite- decreased since 6days
Sleep- normal
Bowel and bladder movements- regular
Addictions- 
Alcoholic since 6 months daily 180ml

FAMILY HISTORY:
Not significant

GENERAL EXAMINATION-
Pt C/C/C
No pallor/Icterus/cyanosis/clubbing/koilonychia/ generalised lymphadenopathy / pedal edema 
Temp- afebrile
PR- 90bpm
BP- 110/80 mmhg
Spo2-97% @RA
SYSTEMIC EXAMINATION -
CVS: S1 S2 +,No murmurs
RS: BAE+, NVBS heard
Abdomen examination:
Inspection: shape of abdomen: normal
Umbilicous: inverted
Scars: absent
Sinuses: absent
Dilated veins : absent
Palpation:
Inspectory findings are confirmed
Tenderness: absent
Hepatomegaly: absent
Spleenomegaly: absent
No local rise of temperature
Percution
Fluid thrill : absent
CNS: intact
ECG:

USG report
ACUTE PANCREATITIS 

Rx:
1.NBM till further orders
2.IVF NS,RL,DNS @100ml/hr
3.INJ.PANTOP 40 mg IV BD
4.INJ.ZOFER 4mg IV SOS
5.INJ.TRAMADOL 1amp in 100ml NS IV TID
6.INJ.THIAMINE 1amp in 100ml NS IV TID
7.GRBS 4th hourly
8.I/O Charting
9.Monitor vitals 4th hrly

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