Man With Epigastric Pain

Abstract

An 84-year-old man presented to the emergency department with a 1-day history of dull epigastric pain, decreased appetite, and frequent hiccups. He had a remote perforated gastric ulcer and had, therefore, undergone subtotal gastrectomy with Billroth II anastomosis. His blood pressure was 150/91 mm Hg and pulse rate was 86 beats/min. A physical examination was noteworthy only for mild epigastric tenderness. His WBC count was 6,760/μL, creatine level was 1.4 mg/dL, lipase level was 1,866 U/L, and total bilirubin level was 0.68 mg/dL.