James R. McPhee

A 12-year-old boy with a 3-week history of abdominal pain, was referred to the emergency room. The patient had been diagnosed with acute pancreatitis at another hospital before he came to see us. Notably after treatment, he went into remission, but relapsed after he started eating again, prompting a referral. He had marfanoid habitus.

Laboratory investigations showed serum amylase concentration of 98 U/L (normal range 40-132) and serum lipase concentration of 143 U/L (normal range 0-60). What is the most likely diagnosis?

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A 75-year-old man with a history of atrial tachyarrhythmias, tricuspid regurgitation, and pericarditis presented with worsening dyspnea, leg swelling, and abdominal bloating after recent catheter ablation.

Encased in Peril | NEJM Clinical Problem-Solving from The New England Journal of Medicine — Encased in Peril