A 50-Year-Old Woman With Unexplained Recurrent Pancreatitis

A 50-year-old woman presents to your emergency department with her second attack of acute pancreatitis. Two months ago she developed severe epigastric pain radiating to the back, associated with nausea and vomiting. She was evaluated and admitted at that time. On admission, she had a lipase of 1725 U/L, AST 45 U/L, ALT 50 U/L, normal alkaline phosphatase and bilirubin, calcium 8.6 mg/dL, albumin 3.8 g/dL, triglycerides 320 mg/dL, and a white blood cell count of 11,000/mm3. She was hospitalized for 5 days, during which time you saw her in consultation.