List common symptoms.
Constant, severe epigastric pain
Classically radiating towards the back
Worse after meals and when supine
Improves on leaning forwards
Nausea, vomiting
Fever
If pulmonary complications are present: chest pain, dyspnea
List general examination findings.
Signs of shock: tachycardia, hypotension, oliguria/anuria
Possibly jaundice in patients with biliary pancreatitis
List findings in the abdominal and pulmonary examination.
Abdominal tenderness, distention, guarding
Ileus with reduced bowel sounds and tympany on percussion
Ascites
Skin changes (rare)
Cullen sign: periumbilical ecchymosis and discoloration (bluish-red)
Grey Turner sign: flank ecchymosis with discoloration
Fox sign: ecchymosis over the inguinal ligament
Pulmonary examination: signs of pleural effusion and/or ARDS may be present
Cullen sign
Periumbilical ecchymosis as a result of retroperitoneal hemorrhage, commonly seen in acute pancreatitis.
Grey Turner sign
Right-sided flank ecchymosis suggestive of retroperitoneal hemorrhage, commonly seen in acute pancreatitis.
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