Answer to yesterday’s quiz: In a patient with an acute onset of gallstone pancreatitis, which one of the following scenarios is not routinely an indication for endoscopic retrograde cholangiopancreatography (ERCP) within 24 to 48 hours after presentation? A. Fever, jaundice, or sepsis. B. Persistent biliary obstruction (a conjugated bilirubin level >5 mg per deciliter). C. A stone in the common bile duct detected on abdominal imaging. D. A serum amylase level greater than 1000 U per liter and a serum lipase level greater than 5000 U per liter. The answer is D. For initial treatment, ERCP within 24 to 48 hours after presentation is indicated in patients with acute disease and symptoms or signs of coexisting cholangitis or persistent biliary obstruction. The results are not dependent on the predicted severity of pancreatitis. nej.md/KxZy8t
Posted on: Tue, 14 Jan 2014 17:00:00 +0000
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