History

Most patients experience abdominal pain, typically epigastric with radiation to the back, coupled with persistent nausea, retching and vomiting. Onset of pain is typically sudden, severe and reaches a maximal level quickly. Pain is relieved by nothing and made worse by movement. Fifty percent of patients will have had similar episodes of pain in the past.

Ask about risk factors, such as known gall stone disease, and also significant comorbidities as these can worsen prognosis. Remember that drugs and toxins can cause pancreatitis when taking a drug history. Always ask about alcohol.