Symptoms:
Severe , constant , agonizing pain in the epigastrium, with radiation to the back.
Nausea , vomiting and retching are usually marked .
Signs:
- Tenderness and guarding disproportionate to symptoms. Generalized Peritonism
- Tachycardia , tachypnia and hypotension indicate severe pancreatitis
- Jaundice: due to impacted stone ? co-existing cholangitis.