A severe case of epigastric pain, diarrhea and coffee ground vomitus
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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?
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...
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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 was obtained from the patient before applying the diagnostic and therapeutic procedures described.
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