<prompt> A 21yrs. old pt. attended a pay the previous night and gives the following symptoms - pain in abdomen radiating to back, pulse 100min, BP 10076 temp 39degC and vomiting before coming Most probable dx is :Acute appendicitisAcute cholecystitisAcute diveiculitisAcute pancreatitis  <response>: Ans. is d ie Acute Pancreatitis The signs and symptoms exhibited by the pt. correlate with that of acute pancreatitis, most characterstic of which is --- Radiation of pain to back and pay in previous night ie. ho alcohol Other imp. diagnostic clue not given in question is -- Relief from pain on sitting in upright posture. Some imp. points about Acute Pancreatitis Etiology Gall stones 50 - 70 ie MC cause Alcohol 25 Grey Turner sign or Cullens sign : Bleeding into the fascial planes in acute pancreatitis can cause bluish discolouration of ? Umbilicus v:shapes_x0000_s1026flanks in Grey Turner sign umblicus in Cullens sign Plain abdominal x-ray findings - include a - sentinel loop - a colon cut off sign - a renal halo sign 