Hi, 2 weeks ago I had an acute onset of epigastric pain, tenderness and inflammation. The next day, the pain had subsided but still tender and inflamed abdomen. I had lipase tested and it was 4890. My doctor had me go to ER next morning and they retested lipase and it was 5100. My pain was minimal and ultrasound showed numerous gallstones but no inflammation. I went home and did clear liquid diet for 5 days. My lipase went down to 790 then 293 by 5th day. I had MRCP which again showed stones, 2 to 2.5mm in size but CBD with no evidence of obstruction or sludge. The GI doctor who I never saw called me and suggested a cholesytectomy. They said I could have 50 grams of fat a day in diet but I get nauseous after eating fat now. I'm down to 98 lbs (normal was 118). This was all preceded in past 6 months by 2 vaccines, Hep A and oral typhoid for trip to Chile which was canceled. I got sick after Hep A vaccination and tested positive for active Epstein Barr virus (with no way of direct exposure). May be chronic reactivated EBV. Then as I was getting better, I took typhoid vaccine early March and 1 week later developed lymphadenopathy right pelvis with compression on femoral nerve. We canceled trip and I've been undergoing tests. CT and MRI showed enlarged spleen but normal everything else. Then this pancreatitis occurred. Do you think an autoimmune cascade was set off? I have preexisting Hashimoto's thyroiditis. I was referred to GI surgeon...should I consider cholesytectomy?
Thank you!