MRCP2-1885

A 42-year-old woman is admitted directly to the high-dependency unit with suspected acute pancreatitis. This is her second attack over the past 2 years and she has a history of heavy alcohol consumption.
During examination, her blood pressure (BP) is 90/50 mmHg, her pulse is 110/min and regular, she has a fever of 38.2 °C and is experiencing intense epigastric pain. Her amylase is confirmed at 1800 U/l. Other blood tests are currently being conducted.
Which of the following symptoms would be indicative of severe pancreatitis?