Pancreatitis may get smashed, but you smashed pancreatitis (321)

Correct!

The raised ALP and GGT along with the high bilirubin suggest there is likely to be obstructive jaundice, which is jaundice caused by obstruction of biliary outflow. The causes of obstructive jaundice include gallstones (most common), cancer of the head of the pancreas, primary biliary cirrhosis, primary sclerosing cholangitis, strictures or extrinsic compression by enlarged lymph nodes.

You should also ask Sally if she has noticed dark urine or pale stools – dark urine would occur due to increased leakage of conjugate bilirubin whereas pale stools would occur due to reduced stercobilinogen in the intestines.

In Sally’s case, as she came in with epigastric pain radiating to the back alongside nausea and vomiting, it is essential to rule out pancreatitis. Sally’s amylase, in fact, was markedly raised leading to a suspicion of acute pancreatitis.

The image of obstructive jaundice along with acute pancreatitis points to the presence of gallstones. An abdominal CT can assess the degree of necrosis and look for complications. 

Further reading: https://www.bsg.org.uk/resource/acute-pancreatitis–recent-advances-through-randomised-trials.html