Clinical features

Sudden onset of severe epigastric pain radiating to the back

Nausea and vomiting.

On examination, there is often epigastric tenderness, with or without muscle guarding.

In severe cases, there may be features of shock.

In case of retroperitoneal hemorrhage, Cullen’s sign (bruising around the umbilicus) and Grey Turner’s sign (bruising in the flanks) may be seen.