Internal and Emergency Medicine

, Volume 13, Issue 7, pp 1097–1101 | Cite as

A severe case of epigastric pain, diarrhea and coffee ground vomitus

  • Claudia Marinucci
  • Federica Zardo
  • Alessandro Musso
  • Paolo Strignano
  • Stefania Morra di Cella
  • Massimo PortaEmail author


Prof. Porta

Dear colleagues,

We discuss today the unusual presentation of a critical condition developed in an elderly patient admitted to our Internal Medicine ward. Will Dr. Marinucci please present the case?

Case presentation

Dr. Marinucci

An 86 year-old woman was admitted to the Internal Medicine ward for epigastric pain, diarrhea and coffee ground vomitus. She reported weekly bouts of diarrhea over the prior year, hypertension and osteoporosis, but was otherwise in good general condition. On admission, vital parameters were normal and the patient only reported upper abdominal pain with a negative Blumberg sign.

Laboratory findings were: white blood cells (WBC) 14.69 × 109/L (reference range 4.00–11.0 × 109/L), C-reactive protein (CRP) 3.9 mg/L (< 3 mg/L), amylase 2500 U/L (40–140 U/L), AST 878 U/L (6–40 U/L), ALT 437 U/L (20–60 U/L), fasting glycaemia 185 mg/dL (72–100 mg/dL); hemoglobin, electrolytes and renal function were normal. At haemogas analysis, pH was 7.33...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patient before applying the diagnostic and therapeutic procedures described.


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Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Department of Medical SciencesUniversity of TurinTurinItaly
  2. 2.Department of GastroenterologyCittà della Salute e della Scienza di TorinoTurinItaly
  3. 3.Department of General SurgeryCittà della Salute e della Scienza di TorinoTurinItaly

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