A 65-years-old lady presented to our Clinic with upper abdominal pain which was spreading to the right side and back, vomiting and backache for 5 days. Treatment from her local family practitioner did not relieve her of pain, so she was referred for further evaluation. Seeing her condition, she was admitted and investigated. Ultrasound revealed swollen gallbladder with multiple small stones, a dilated common bile duct of 7mm and edematous pancreas. She was admitted, and immediate investigations & treatment were instituted. Abdominal examination was notable for marked tenderness (pain on pressing while examining) in the upper abdomen in the centre. Further, blood tests were suggestive of severe infection and pancreatic enzymes were raised (serum amylase & serum lipase - markers of pancreatic infection). Fortunately, the liver function tests were normal. Final diagnosis was - Gallstone induced Pancreatitis.

As a first step, she was started on intravenous fluids, kept nil by mouth, intravenous antibiotics, anti-acidity medications, painkillers and pancreas swelling reducing medication. A tube was passed into the stomach to drain the intestinal juices. After 3 days, her white blood cell count, serum amylase and lipase showed a lowering trend. She was gradually allowed liquids and then started on soft diet.
She was discharged after 7 days and a Cholecystectomy surgery was planned after three weeks. The options of open and laparoscopic surgery were discussed with the patient and her relatives. Considering her age, there were reservations about laparoscopic surgery but after due assessment & preparation a successful laparoscopic cholecystectomy was performed. She was discharged on fourth post-operative day.