Recurrent Acute Pancreatitis Over in Medicine / Internal Medicine — 48yo Man | Gastroenterology | SMLE Q#11572

SMLE Question #11572

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-433

Last updated: February 2026
A 48-year-old man with recurrent acute pancreatitis over 2 years reports severe epigastric pain radiating to the back and nausea during attacks. He drinks alcohol only occasionally and has no history of gallstones or abdominal trauma. Prior contrast CT showed splenomegaly and prominent veins at the gastric fundus without cirrhosis or portal vein thrombosis. Upper endoscopy now shows isolated fundal gastric varices with normal esophageal veins. Which of the following is the most likely underlying diagnosis explaining these findings?

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