A 30 year old with persistent vomiting and epigastric pain over 1 week (presented by 3rd semester MBBS Ravi Jain, Souptik Biswas and Avinash Kumar)

Title:- A 30 year old with persistent vomiting and epigastric pain over 1 week (presented by 3rd semester MBBS Ravi Jain, Souptik Biswas and Avinash Kumar)

Disclaimer:-

This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here december 2016 after collecting informed patient consent (form downloadable here) by BMJ Elective Student.

A 30 years old woman

presented with

the complaints of:

Subjective -


Persistent Vomiting - greenish yellow colored. 8-9 times
Heart Burn
Pain abdomen, in epigastric region,
Fever
Sleep improper
Didn’t pass stool for 5-6 days

She was suffering from pain in the stomach since 8-9 days before admission

Objective -

General examination and abdominal examination: (to be filled up by Ravi Jain and Souptik using this link:  https://www.ucl.ac.uk/pcph/undergrad/cbt/year4/history-and-examination

Investigations:

WBC count increased (11,700)
Hb Normal
MCH decreased (26.
S. creatine decreased (0.6)
A:G decreased (1.1)

Initial clinical assessment of the student -
Stomach tumor
Acute Pancreatitis

Student queries on reflection (More about the learning and assessment methodology here :http://globaludhc18.blogspot.in/2015/12/formative-assessment-of-2014-batch-3rd.html)

Q. - 1. Why heart burn?
Q. - 2. Why she didn’t pass stool for 5-6 days?

Later more objective findings below: