26 year old male with Interstitial Pancreatitis

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 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current based inputs.

Patient is a 26 year old male, car driver by occupation came to the casualty at 1am with complaints of : 

• pain abdomen since 1 day
• 4-5 episodes of vomitings

History of presenting illness

Patient was aymptomatic 6 months back. Then he developed pain abdomen not associated with vomitings not admitted to PE hospital. Subsided on taking medication (augmentin, Tramadol) 

Now today at 1am the patient developed pain abdomen sudden in onset and associated with 2 episodes of vomitings which were bilious. 

Had similar complaints in the past around 12 years back. 

History of past illness

He was a k/c/o acute pancreatitis, diagnosed 1 week back and treated at a local hospital.
He was a chronic alcoholic but stopped drinking 1month ago.

N/K/C/O DM,HTN,TB,thyroid disorders,epilepsy

Personal History

Married 
Car driver by occupation 
Diet: mixed 
Appetite: lost
Bowel bladder moments: regular
Addictions : Chronic alcoholic, stopped 1 month back. 

Family history: Not significant

On examination

Pt is conscious,coherent and cooperative well oriented to time,place,person 

No signs of pallor,icterus,clubbing,cyanosis,lymphadenopathy,pedal oedema 

Vitals

Temp:98.6°F
PR: 82
Rr: 16/ min
Bp:120/70 mm Hg. 
Spo2: 98%
GRBS:102mg%

Systemic examination

CVS: S1,S2 heard, no murmurs heard 
Resp: BAE +
CNS :NAD 

Abdomen: 
Soft, mild tenderness in epigastrium & left hypochondrium no guarding, non ? Bs + 



Investigations:

HCV, HIV , HbsAg : negative
Blood Urea : 14mg/dl
Sr. Creatinine: 0.8 mg/dl
CRP : 2.4 mg/dl 

FBS: 86 mg/dl

Blood group : A+ 

Hemogram 
Sr. Electrolytes 
2D Echo 

Ultrasound 

ECG 

Culture & Sensitivity


 Provisional diagnosis: Interstitial Pancreatitis

Treatment History 

Day 1 

NBM TIL FURTHER ORDERS

• INJ TRAMADOL IN 100ML NS TID 

• INJ PAN 40 mg OP IV

•INJ ZOFER 4mg IV 

• INJ CIPROFLOXACIN 500mg IV BD 

• IV fluids NS /RL / DMS (@75 ml/min)

 GRBS -every 6th hourly 

BP every 4th hourly 

Day 2 

• INJ TRAMADOL 1amp IN 100ML NS TID 

• INJ PAN 40 mg OP IV

•INJ ZOFER 4mg IV 

• INJ CIPROFLOXACIN 500mg IV BD 

• IV fluids NS /RL / DMS (@75 ml/min)

 GRBS -every 6th hourly 

BP every 4th hourly 

Day 3 

• INJ TRAMADOL IN 100ML NS TID 

• INJ PAN 40 mg OP IV

•INJ ZOFER 4mg IV 

• INJ CIPROFLOXACIN 500mg IV BD 

• IV fluids NS /RL / DMS (@75 ml/min)

 GRBS -every 6th hourly 

BP every 4th hourly 

Day 4 
STARTED ORAL SIPS OF FLUID 

INJ TRAMADOL 1amp IN 100ML NS TID 

• INJ PAN 40 mg OP IV

•INJ ZOFER 4mg IV 

• INJ CIPROFLOXACIN 500mg IV BD 

• IV fluids NS /RL / DMS (@75 ml/min)

BP/  GRBS -every 6th hourly 

Day 5  

T. TRAMADOL PO/OD 

T. ZOFER 4mg PO BD 

T. PAN 40 mg PO OD 

INJ CIPROFLOXACIN 500mg IV BD 




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