Question
Admitted on July 3rd with abdominal pain, vomiting, and diarrhea, with elevated urinary amylase and normal blood amylase, increased white blood cells, and a normal ultrasound. On July 4th, recheck showed normal blood and urine amylase, normal thyroid function, and tumor markers. Albumin was slightly low, alkaline phosphatase was normal. Endoscopy revealed gastritis and gastric antrum erosion with a negative HP test. Discharged on July 8th. On the evening of July 17th, fever, diarrhea, and mild abdominal pain recurred, with body temperature dropping after taking antipyretics and antibiotics. Request for diagnostic opinion.
Answer
Based on the above symptoms and examination results, the preliminary diagnosis is gastroenteritis. Upon admission on July 3rd, the patient had elevated urinary amylase, possibly due to pre-renal factors caused by diarrhea, while the normal blood amylase indicated the presence of infection. On July 4th, recheck showed normal blood and urine amylase, along with other related tests like thyroid function and tumor markers being normal, excluding some systemic diseases. The slightly low albumin may be related to disease stress, while alkaline phosphatase was normal. Endoscopy revealed gastritis and gastric antrum erosion.