Sonu, a 30 year old chronic alcoholic presents with sudden onset of epigastric pain that radiates to the back. All are seen, EXCEPT:

Chronic alcoholic patient with sudden onset of epigastric pain which radiates to back, most probably is suffering from acute pancreatitis. Acute pancreatitis is usually confirmed by an elevated level of serum amylase and/or lipase. Biochemical findings in acute pancreatitis Serum amylase level is increased many folds. Serum lipase level is also increased. Serum LDH level are elevated and markedly elevated levels suggest a poor prognosis. Hypocalcemia is seen in about 25% of patients and is thought to be due to intraperitoneal saponification of calcium by fatty acids in areas of fat necrosis. Another lab test used to diagnose acute pancreatitis is serum trypsin levels. It has theoretical advantage over amylase and determinations in that the pancreas is the only organ that contains this enzyme. Ref: Harrison 17/e, Page 2002