Diagnosis of acute biliary pancreatitis in the absence of imaging findings

Acute pancreatitis is defined as a sudden inflammation of the pancreas, which can range from a mild state to organ dysfunction.We present a 63-year-old male patient who was admitted with epigastric pain radiating to the back for 3 days, associated with oral intolerance.Suspecting acute pancreatitis, studies were requested that revealed elevated lipase as well as liver enzyme abnormalities, thus suggesting a biliary etiology; therefore, conservative treatment was initiated.In conclusion, this case emphasizes the relevance of clinical judgment and early management, demonstrating that a favorable outcome can be achieved even when imaging studies fail to confirm a biliary etiology.