How is dx of acute pancreatitis?

Pain (epigastric, knifing, relieved leaning forward) PE (tachycardia, tachypnea, hypotension, fever, guarding, decreased bowel sounds, maybe distended abdomen and PE Cullen's sign/ Grey Turners sign) Investigation (hemoconcentration, BUN, hyperglycemia, hypoalbuminemia, hypocalcemia) Serum markers (amylase and lipase [2-3 days after amylase, false positive [do p amylase, if >3x normal ->dx], false negative [alcoholic hepatitis may see normal amylase]) ALT>3 times normal found 50% of cases of acute GS pancreatitis