Gallstone pancreatitis

Discussion:

For this patient, the lipase was >1500 U/L (exceeds assay range of analyzer). 

Combination of findings of cholelithiasis, stones in the cystic duct, choledocholithiasis, and acute interstitial pancreatitis. This makes the diagnosis of gallstone pancreatitis almost certain, although no definite stone is seen at the level of the ampulla. 

The inflammation of the gallbladder is favored to be reactive in the setting of acute pancreatitis; however, given the stones in the cystic duct, superimposed acute cholecystitis would also be possible and correlation with laboratory and physical examination findings was recommended.

Also note massive amount of stool in the rectum with wall thickening, placing the patient at risk for stercoral colitis.

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