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 BOF 60

 

   

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BOF: 60

A 45-year-old male presents with abdominal pain of several hours duration.  He also complains of severe vomiting. There is no past history of note and he is not on any medication. He drinks more than 60 units of alcohol per week and had been on an alcoholic binge for 2 days prior to presentation.

On examination he looked unwell, his skin was cold and clammy. Pulse rate of 110 beats per minute blood pressure 100/60.

Abdominal examination revealed diffuse tenderness with absent bowel sounds

Investigations

Hb 13 g/dL

WBC 15 x109 /L

Sodium 144 mmol/L

Potassium 4.0 mmol/L

Urea 9 mmol/L

Albumin 27 g/L

Corrected calcium 1.9 mmol/L

Phosphate 0.7 mmol/L

In this patient which one of the following investigations would you arrange next in order to substantiate your clinical diagnosis?

a)      Serum amylase

b)      Ultrasound scan

c)      ERCP

d)      Blood gas analysis

e)      Plain X-ray abdomen

 

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