Posted by Athena Kritharis MS-3, Vivian Hayashi MD, Instructor of Clinical Medicine, Division of General Internal Medicine and Robert Smith MD, Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine
The patient is a 42 year old Caucasian woman with no significant past medical history who presents with diffuse abdominal pain for two months that progressed to acute epigastric pain followed by nausea and vomiting. The vomitus was “milky” and contained only food particles. Symptoms were not relieved with over-the-counter antacids. The patient recalls eating scallops the night before presentation. The patient’s history is also significant for an umbilical hernia repair and three uncomplicated vaginal deliveries. The patient takes Chinese herbs and drinks alcohol socially, but no elicit drugs nor tobacco use. A CT scan with contrast of the abdomen was obtained.