Abstract
A 50-year-old Caucasian male presented to the emergency department with worsening abdominal pain more than 6 h associated with nausea and dizziness. The pain was dull in nature periumbilical with no radiation. He denied hematemesis, hematochezia, trauma, fever or change in urine/bowel habits. Past medical history was positive for diabetes, hypertension and intravenous (IV) heroin abuse. On arrival, he was lethargic and vital signs were remarkable for sinus tachycardia 122 per min, 61/40 mm Hg blood pressure and respiratory rate of 25 cycles per minute. Abdominal examination showed generalized tenderness more prominent in the left upper quadrant with no rebound. Apart from faint …
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