A 23 y/o/m presents to the Tac-Med Clinic complaining of abdominal pain and dark, tarry stools. The man, a construction worker, tells you of a dull abdominal pain over the past several months that has gotten worse over the past week, culminating in his visit to the TM Clinic. He has no medical history, aside from what he describes as pain of the job, and he medicates his musculoskeletal at home with ibuprofen and other OTC analgesics. Today, he describes the pain as sharp and constant. It is epigastric without radiation and worse with deep palpation. Otherwise, his physical exam is unimpressive. His vital signs at admission are: 112, 94/72, 99%, 20. As you turn your back to the patient to go chart and order some tests, he screams out in pain, grabs his stomach, and falls unconscious. He awakes 30 seconds later in severe pain. Re-examination finds his abdomen now severely tender to even the slightest palpation, and more taut than your earlier examination. What might be happening here?
Posted on: Fri, 23 May 2014 13:10:55 +0000
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