acute pancreatitis

Pt aged 45 years old male came to opd with chief complaints of vomitings ,abdominal pain and low grade fever since 1 day

HOPI-:Patient was apparently asymptomatic 1day back then he developed sudden vomitings, abdominal pain and low grade fever
PAIN-:
Type-:dragging type of pain 
Site -:epigastric region 
VOMITING-:4-6 BOUTS IN A DAY
        TYPE-:BILIOUS TYPE OF VOMITING
No h/o-:constipation 
No h/o-:loose stools
ALCHOHOL HISTORY-:Since 5years with a gap of 1 year in between and again continuing since 3-4months 
Quantity-:1beer/day

HISTORY OF PAST ILLNESS-:
                    similar complaints in the past 5 years ago
N/K/C/O-: diabetes ,TB,asthma ,epilepsy,Hypertension 

PERSONAL HISTORY-:
         Diet-:mixed
         Appettite-:normal 
         Bowel and bladder -:regular
        Sleep-:normal
         Addictions-: alcohol--->regular
                                1beer/day

FAMILY HISTORY-:no similar complaints in family members 

GENERAL EXAMINATION-:
NO SIGNS OF -: PALLOR
                            ICTERUS
                            CLUBBING
                            CYANOSIS
                            LYMPHADENOPATHY 

VITALS-: 
             Temp-:98.7f
             Pulse rate-:66
            Bp-:120/80
            Spo2-:97
            Resp rate-:12cycles/min 
  
SYSTEMIC EXAMINATION 
       CVS-: No thrills heard
                  Heart sounds normal
                   No murmurs heard

      RESPIRATORY -:
                   No dyspnea,wheeze
                    Position of trachea -central 
       ABDOMEN-:
                     SHAPE-:scaphoid
                     Tenderness-:+ve in epigastric region
                  No palpable masses 
                  No free fluid 
                  Liver-:not palpable
                  Spleen-: not palpable
                 Bowel sounds -:heard


INVESTIGATIONS-:
           SERUM AMYLASE-:
   
          SERUM LIPASE-:
      
            SERUM CREATININE-:
   
       
          SERUM UREA-:
TREATMENT-:
INJECTION TRAMADOL 
INJECTION THIAMINE

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