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Causes (I GET SMASHED) * I Idiopathic * G Gallstones (most common overall) * E Ethanol (alcohol) * T Trauma * S Steroids * M Mumps and other infections * A Autoimmune pancreatitis * S Scorpion sting (rare) * H Hypertriglyceridemia/Hypercalcemia * E ERCP * D Drugs (e.g., azathioprine, valproate) Clinical Features * Sudden severe epigastric pain radiating to the back * Nausea and vomiting * Epigastric tenderness * Fever * Tachycardia * Abdominal distension * Reduced bowel sounds (ileus) Severe disease: * Hypotension * Shock * Respiratory distress * Oliguria * Confusion Signs * Epigastric tenderness * Guarding * Dehydration * Cullen sign (periumbilical ecchymosis) * Grey Turner sign (flank ecchymosis) Investigations Blood Tests * Serum lipase (preferred

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