Which of the following is a commonly used initial management step for suspected acute pancreatitis?

• A. Abdominal ultrasound
• B. CT scan without contrast
• C. Endoscopy
• D. Barium swallow

Answer: (A)

In suspected acute pancreatitis, the first priority is supportive care, but when it comes to imaging used early to guide management, an abdominal ultrasound is the best initial choice. It’s quick, noninvasive, and can reliably detect gallstones or biliary obstruction, which are common causes of pancreatitis and can change treatment (for example, prompting urgent management of biliary disease).

A CT scan without contrast isn’t the first step; it’s typically reserved if the diagnosis is uncertain after initial evaluation or to assess complications in severe or worsening cases, because early CT may miss mild pancreatitis and contrast carries risks. Endoscopy and a barium swallow aren’t indicated for evaluating or managing pancreatitis.