An Unexpected Diagnosis Underlying Acute Necrotizing Pancreatitis

Abstract

Question: A 65-year-old man with a past medical history of diabetes mellitus and prostate cancer in remission (prostate specific antigen 0.41 ng/mL) presented with intractable severe abdominal pain accompanied by nausea and nonbloody, nonbilious emesis that developed during the past day. The patient’s medications included metformin monotherapy and he did not have a history of tobacco or alcohol use disorder, and he had no known family history of gastrointestinal malignancies. On evaluation, patient was afebrile with vital signs notable for tachycardia at 105 beats per minute.