Pancreatitis & Gallbladder Disease

Acute pancreatitis is most commonly caused by gallstones or heavy alcohol use, presenting with severe, steady epigastric pain that often radiates to the back and may ease slightly when the patient leans forward — nausea and vomiting are common, and the hallmark diagnostic findings are elevated serum lipase (more specific to the pancreas) and amylase. Management is largely supportive: the patient is kept NPO initially to rest the pancreas and reduce further enzyme stimulation, IV fluids are given aggressively to support perfusion (pancreatitis can cause significant third-spacing of fluid), and pain control is a priority given the severity of the pain. A key, frequently tested lab pattern is hypocalcemia, not hypercalcemia, in pancreatitis — calcium becomes bound up in the areas of fat necrosis the inflamed pancreas can cause, so a falling calcium level alongside pancreatitis is an expected, monitored finding, and the nurse watches for related signs like tetany or a positive Chvostek's/Trousseau's sign.