Year 4middle twist
A 45-year-old woman presents to the emergency department due to the sudden onset of nausea, vomiting, and epigastric pain radiating to the back for the past 6 hours. The pain worsens when the patient lies supine and relieves when the patient leans forward.
On examination, there’s epigastric tenderness but no signs of rebound tenderness or rigidity. The patient’s BMI is 35 kg/m², and she has a history of hyperlipidemia and multiple episodes of biliary colic.
Laboratory results show the following:
· Serum amylase: 620 U/L (Normal: 30–110 U/L)
· Serum lipase: 1,800 U/L (Normal: 10–140 U/L)
What is the most appropriate initial investigation to confirm the diagnosis?