患者，女，32岁，饱餐后出现上腹部剧痛伴恶心、呕吐，呕后腹痛反而加重，服解痉剂无效。检查：体温39℃，心率120次/分，多汗，上腹部紧张，有压痛、反跳痛，血清淀粉酶350U/L，血钙163mmol/L。应首先考虑的是

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