Chronic pancreatitis Quiz: Ace Your Exams

A 53-year-old woman presents to the emergency department with worsening abdominal pain over the past two days. The patient has had several recurrent episodes of acute pancreatitis and typically drinks a 750 mL bottle of vodka daily. During this past year, the patient has developed mild and constant epigastric pain, oily stools, and she has lost 15 lbs (6.8 kg) unintentionally. The current abdominal pain is significantly worse than what she has been experiencing regularly this past year and interferes with her ability to give a history. Previous abdominal CT imaging showed atrophy of the pancreas and heavy intraductal calcifications. Temperature is 37.0 °C (98.6 °F), pulse is 102/min, respiratory rate is 18/min, and blood pressure is 135/78 mmHg. On physical examination, the patient is thin with sarcopenia and temporal wasting. Bowel sounds are normoactive. There is significant epigastric tenderness to palpation without rebound or guarding. Which of the following is the best next step in management?