Essentials of Diagnosis:-

• Sudden, severe epigastric pain with radiation to back in an alcoholic or in those with known biliary disease.
• Fainting attacks, sweating, vomiting.
• Fever, leucocytosis, paralytic ileus in some patients.
• Elevated serum and urinary amylase and lipase.
• History of previous episodes specially after dietary


– Nil orally. Fluid and electrolyte balance to be maintained.
-Several litres of IV fluid replacement as patient is invariably dehydrated.

-Continuous gastric suction to reduce vomiting and distension of gut.
-For pain, injection Pethidine 100 mg IM or Morphine 15 mg IM.
-Injection Atropine 0.6 mg IM or injection Proban- theline 15-30 mg six hourly to reduce gastric, duo- denal and pancreatic secretion and to relieve spasm of sphincter of oddi.
-Antibiotics for secondary infection—Injection Ampicillin 500 mg 6 hourly and Gentamycin 60-80 mg eight hourly.
– Calcium gluconate 10 per cent as 10 ml slow IV twice or thrice if serum calcium is low.
– Liquid Gelucil or Divol or Siloxagen one table spoonful hourly through Ryle’s tube.
-If respiratory distress then oxygen.

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