In suspected acute pancreatitis, which combination of tests is most appropriate to evaluate liver and pancreatic involvement?

• A. Liver function tests, amylase, and abdominal films
• B. ESR, urinalysis, and electrolytes
• C. Electrolytes, ECG, and upper GI
• D. ECG, barium enema, and sonogram

Answer: (A)

When pancreatitis is suspected, you want to confirm pancreatic involvement and assess potential biliary or liver causes. Measuring a pancreatic enzyme such as amylase helps support a diagnosis of pancreatitis, since these enzymes rise with pancreatic inflammation. At the same time, evaluating liver function tests provides information about the biliary system and liver—the common cause of pancreatitis is gallstones or biliary obstruction, which can be suggested by abnormal bilirubin, alkaline phosphatase, or transaminases. Abdominal imaging adds supportive information about the bowel and abdominal organs and can reveal complications or signs of pancreatitis, such as ileus or ductal changes, while not being specific on its own.

The other options miss this combination: they either focus on non-specific inflammatory markers or tests that don’t directly assess pancreatic and biliary involvement, or they include studies (like ECG or enema studies) that aren’t helpful in evaluating suspected pancreatitis.