• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Upper Abdominal Pain, No Relief from Pepto-Bismol: Seen in the ED

Quiz
Article

A man in his mid-sixties reports constant bilateral chest pain that radiates to the back that began yesterday. Can you Dx based on the CT image here?

Upper Abdominal Pain, No Relief from Pepto-Bismol: Seen in the ED image credit D Brady Pregerson, MD
Brady Pregerson, MD

History of present illness. A man in his mid-sixties with a history of endoscopy-confirmed gastroesophageal reflux disease (GERD) and esophagitis presents to the emergency department with epigastric/chest pain. He reports constant bilateral chest pain radiating to the back since the day before. He denies any aggravating factors, shortness of breath, nausea, or vomiting. He took Pepto-Bismol with minimal relief.

Vital signs & physical examination. Vital signs are normal except for elevated blood pressure (190/115 mm Hg). Other than mild epigastric tenderness, the physical examination is otherwise unremarkable.

Initial diagnostic testing

CBC: normal

CRP: 2.4

Blood chemistry: bilirubin 1.3/0.4 mg/dL, ALT/AST 120/60 U/L

Imaging: see CT below


What is the most likely diagnosis?


Related Videos
© 2024 MJH Life Sciences

All rights reserved.