Female patient aged 13 years and 7 months who consulted for abdominal pain and vomiting of 2 days' duration.
Family history: of no interest. Personal history: Bolivian origin. She arrived in Barcelona 3 weeks ago due to family reunification (her mother has been in Barcelona for 5 years). Menarche 4 months ago. No previous pathologies of relevance.
Current illness: abdominal pain of 2-3 days' evolution, diffuse, radiating to the epigastrium, sometimes accompanied by vomiting. No alteration in stool rhythm. She attended an emergency department where she was prescribed ranitidine and omeprazole. She came to the emergency department due to persistence of the symptoms. The patient reports that, while in her country, she has had 2 episodes of isolated abdominal pain in the last 2 months, which she has related to menstruation. She is expecting her period in the next few days. It is therefore recurrent abdominal pain.
Physical examination: afebrile, good general condition, good hydration of the skin and mucous membranes, good colouring. Truncal obesity. Soft and depressible abdomen. Diffuse abdominal pain on palpation in the epigastrium and flanks. No abdominal masses palpable. Normal peristalsis. Lumbar fist percussion: negative. Cardiorespiratory auscultation normal. ENT: normal. Neurological examination: normal.
Complementary examinations: once the case has been oriented with the data from the clinical history, the tests will help us to eliminate or confirm the organic cause. In our case, the study began with a blood analysis and abdominal ultrasound which showed: Ht 37.8% Hb 13.4 g/dl, platelets 338,000/ml, leukocytes 7,700/ml (N 46%), platelets 338,000/ml, leukocytes 7,700/ml (N 46%).700/ml (N 46%); glucose 79 mg/dl, creatinine 0.55 mg/dl, protein 77 g/l, albumin 41 g/l, total bilirubin 2.1 mg/dl, cholesterol 206 mg/dl, ALT 475 IU/L, AST 215 IU/L, GGT 243 IU/L, amylases 427.8 IU/L, lipase 1298 IU/L. Abdominal ultrasound: bile duct poorly distended with an image of lithiasis of 15 mm. Pancreas not assessable due to intestinal gas interposition.
Final diagnosis and evolution: a case of acute pancreatitis secondary to biliary lithiasis. The patient was admitted to hospital and discharged one week later. Five days after discharge, she presented a new episode of the same symptoms, so she was admitted again and a cholecystectomy was scheduled, after which the patient has not presented any further episodes of abdominal pain.

