A new patient shows moderate epigastric pain and N/V. Which sign does not indicate acute pancreatitis?

In the context of acute pancreatitis, the presence of hyperactive bowel sounds is not typically associated with this condition. Acute pancreatitis often leads to a physiological state characterized by decreased bowel motility. This is due to the inflammatory processes in the abdomen that can cause paralytic ileus, resulting in reduced or absent bowel sounds rather than an increase.

Guarding on palpation, hematemesis, and tenderness on palpation are all signs that may indicate complications or the severity of an abdominal issue such as acute pancreatitis. Guarding suggests the presence of abdominal pain that may indicate irritation of the peritoneum, while tenderness on palpation directly correlates with acute abdominal pain. Hematemesis (vomiting blood) can indicate a severe complication, such as the development of pancreatitis-related hemorrhagic necrosis.

In contrast, hyperactive bowel sounds do not fit the typical clinical scenario for acute pancreatitis, where bowel sounds tend to be diminished or absent. Thus, hyperactive bowel sounds are not a sign that indicates the presence of acute pancreatitis.