DOI: 10.1373/clinchem.2011.167452


A 43-year-old man with a history of acute and chronic pancreatitis presented with a 1-day history of severe burning and squeezing epigastric pain without nausea, vomiting, or diarrhea. The pain was similar to the patient's previous episodes of acute pancreatitis, for which he had had multiple hospitalizations. The patient's other diagnoses were hypertriglyceridemia, chronic kidney disease, and diabetes. On physical examination, the patient was afebrile and his abdomen was firm, with epigastric tenderness, guarding, and decreased bowel sounds.