Q. A 38-year-old man comes to the emergency department because of severe abdominal pain that radiates to his back and multiple episodes of nausea and vomiting in the past 48 hours. When lying down, his HR is 92 bpm and his BP is 115/72. When standing, his HR is 125 bpm and his BP is 92/55 mmHg. RR is 20 bpm, and his temperature is 38°C. He has smoked 2 packs of cigarettes a day for the past 25 years. Although he reports that he only drinks a "couple of beers" per day, his son disagrees and says that the patient has been consuming sometimes up to 30 beers in a day.
On examination, he has severe epigastric tenderness and periumbilical ecchymosis.
Serum studies show normal CBC and BMP. Lipase is 950 units/liter (U/L) (normal is less than 160 U/L) and amylase is 435 U/L (normal is less than 140 U/L). Alkaline phosphatase level is 78 U/L (normal is between 44 - 147 U/L).
Abdominal/Pelvic CT is ordered. Results are shown below.
Which of the following is most appropriate in the management of this condition?