Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 533

Patients with acute pancreatitis characteristically present with moderate to severe abdominal pain, often leading to hospital admission. The pain of pancreatitis usually occurs in the epigastrium and radiates through to the back and may be relieved by sitting forward. However, this presentation may differ in the elderly, and therefore pancreatitis may be confused with myocardial infarction or a perforated abdominal viscus.

The physical signs are those of an acute abdomen. Vomiting, fever, tachycardia, and hypotension may occur. Jaundice may also be a feature if there is concomitant biliary obstruction or cholangitis. Rarely, haemorrhagic pancreatitis can lead to retroperitoneal haemorrhage, causing bruising in the flanks (Grey Turner’s sign), around the umbilicus (Cullen’s sign) or even below the inguinal ligament (Fox’s sign).