CASE REPORT: ACUTE PANCREATITIS, REVISED ATLANTA CLASSIFICATION – MODERATELY SEVERE (GRADE II)

Abstract

Acute pancreatitis (AP) is a common and potentially life-threatening inflammatory condition of the pancreas, predominantly triggered by gallstones or alcohol use. We present the case of a 38-year-old male who arrived at the emergency department with severe epigastric pain radiating to the back, nausea, vomiting, and a history of chronic alcohol consumption. Laboratory investigations confirmed markedly elevated serum amylase and lipase levels. Abdominal CT imaging demonstrated peripancreatic fluid collections, focal areas of necrosis, and surrounding fat stranding, consistent with moderately severe acute pancreatitis (Grade II) as per the Revised Atlanta Classification. The patient was managed with aggressive intravenous fluid resuscitation, bowel rest, analgesics, antiemetics, and prophylactic antibiotic coverage. Nutritional support was initiated via nasojejunal feeding on Day 3. The clinical course was complicated by hypocalcaemia and transient hyperglycaemia, both of which were corrected. The patient showed marked clinical improvement by Day 7 and was discharged on Day 10 with dietary counselling and abstinence advice. This case highlights the importance of timely diagnosis, risk stratification, and aggressive supportive management in achieving favourable outcomes in acute pancreatitis.