A 72-year-old female presents with acute onset severe epigastric pain radiating to her back, nausea, and vomiting. She has a history of gallstones. On examination, she is tachycardic, and her abdomen is tender in the epigastrium with guarding. Labs reveal elevated lipase and amylase, and an abdominal ultrasound shows cholelithiasis without common bile duct dilation. What is the most appropriate initial management for this patient?
✓ Correct Answer: Option B
This presentation is consistent with acute pancreatitis due to gallstones. Initial management focuses on supportive care: aggressive intravenous hydration, pain control, and bowel rest (NPO). ERCP is indicated for cholangitis or severe biliary obstruction. Cholecystectomy is usually performed after inflammation subsides. Antibiotics are not routinely indicated.