Man with Left Upper Quadrant Pain

Abstract

A 37-year-old man with liver cirrhosis and chronic pancreatitis presented to the emergency department with a 4-day history of dull left upper-quadrant abdominal pain accompanied by fever and chills. Three weeks previously, he had undergone endoscopic retrograde cholangiopancreatography and drainage for obstructive pancreatitis. On examination, his blood pressure was 127/87 mm Hg, pulse rate was 147 beats/min, and temperature was 39.1 °C. He experienced tenderness over the epigastrium and left upper quadrant.