A 45-year-old man presents to the emergency department with severe epigastric pain radiating to his back, nausea, and vomiting. His clinical presentation raises suspicion for acute pancreatitis. The medical team needs to confirm the diagnosis with the most reliable investigation.
Which of the following is the most reliable investigation in a suspected case of acute pancreatitis?
A. Serum amylase
B. Endoscopy
C. CT scan
D. LFT
E. Serum electrolytes
Answer:
The Correct Answer is: C. CT scan
Explanation:
CT scan (C):
– It is the gold standard for diagnosing acute pancreatitis.
– A CT scan of the abdomen is the most reliable investigation for diagnosing acute pancreatitis. It can confirm the diagnosis, assess the severity of the inflammation, identify complications such as necrosis, pseudocysts, and abscesses, and guide treatment decisions.
– CT scans provide detailed images of the pancreas and surrounding structures, making them invaluable for evaluating the extent of the disease.
Explanation of Incorrect Options:
Serum amylase (A):
– Serum amylase levels are often elevated in acute pancreatitis, but they are not specific to the condition and can be elevated in other abdominal conditions such as perforated ulcers or intestinal obstruction. Amylase levels can also return to normal within a few days despite ongoing inflammation.
Endoscopy (B):
– Endoscopy is not typically used to diagnose acute pancreatitis. It may be useful for evaluating complications like gallstones or performing therapeutic procedures like ERCP in certain cases, but it is not the primary diagnostic tool.
LFT (D):
– Liver function tests (LFTs) can provide information on liver function and may be elevated in cases of gallstone pancreatitis, but they are not specific for diagnosing acute pancreatitis.
Serum electrolytes (E):
– Serum electrolyte levels can help assess the patient’s overall metabolic state and identify complications such as hypocalcemia, but they are not diagnostic for acute pancreatitis.
In conclusion, a CT scan is the most reliable investigation for diagnosing acute pancreatitis, making option C the correct answer.