1. The possible diagnosis is acute pancreatitis. This condition is commonly characterized by pain in the abdominal region of the patient, which is also main complaint of the 45-year-old patient upon presentation at the emergency room. Pain associated with acute pancreatitis may range from mild to severe. Another sign of acute pancreatitis is vomiting and the patient was also experiencing this characteristic. Since the pancreas is also involved in generating enzymes that are important for digestion, any dysfunction with regards to this organ will result in an uncomfortable feeling in an individual.
The patient has expressed that the abdominal pain occurs right after eating. Pancreatitis is generally caused by an inflammation of the particular organ and it is understood that when an inflammation is caused by an infection of the pancreas, then fever will be observed in the patient. Upon presentation at the emergency room, the patient also complained of fever. The pancreas is also located right underneath the liver, which is located below the rib cage and subscapular area. The patient was complaining of pain in the same area where the pancreas is located.
Upon palpation of the liver, it has been observed that there was tenderness in the right upper quadrant of the abdominal region of the patient. Palpation also indicated that the liver was slightly enlarged. 2. The laboratory tests conducted on the patient further supports the diagnosis of acute pancreatitis. The two main indicators for acute pancreatitis are the high levels of amylase and lipase enzymes in the blood. The patient showed an amylase level of 750 U/L, where the normal level of amylase is 53 to 123 U/L.
The lipase enzyme level of the patient was 200 U/L, while the normal level is 10 to 150 U/L. The laboratory result for the patient’s white blood cell count was also elevated at 15 X 109/L, when the normal range is 4-11 x 109/L. The high white blood cell count indicates that the patient is indeed suffering from an inflammation, as presented by her chief complaint of abdominal pain. The test results also showed that the patient had an elevated number of neutrophils, with a value of 11 x 109/L, when the normal range is 2 to 7. 5 x 109/L.
This significant increase in the number of neutrophils also indicates that the patient has an inflammation. The AST level of the patient was tremendously higher than the normal range of 7 to 27 U/L. The patient’s AST level was determined to be 85 U/L. The ALT level of the patient was also high at 100 U/L, when the normal range is 1 to 21 U/L. Protein assays also provide information regarding the condition of the patient. The alkaline phosphatase level of the patient was high at 240 U/L, when the normal range is 50 to 160 U/L.
In addition, the total bilirubin level of the patient was also markedly increased at 3. 5 mg/dL, when the normal value is 1. 0 mg/dL. Direct bilirubin reading of the patient was 2. 0 mg/dL, higher than the normal value of 0. 4 mg/dL. The urinalysis bilirubin level of the patient showed a 1+ result. It should be understood that the amylase and lipase levels of a patient with acute pancreatitis are high on the first day of inflammation and these levels eventually decrease within three to seven days.
The enzyme lipase is generally employed for diagnosing acute pancreatitis because it is more closely linked with this type of inflammation. However, both lipase and amylase may still be checked for laboratory testing in order to determine whether the patient is experiencing renal failure, as well as other gastroenterological conditions. The two enzymes may also be employed to verify gastric ulcers, occlusions of the mesentery and obstruction of the intestinal region.