Young Man with Epigastric Pain

Abstract

A 29-year–old otherwise healthy man sustained epigastric and periumbilical pain for 3 days before his emergency department visit. The pain was intermittent, dull, without radiation, and not associated with posture change or food ingestion. On arrival, his vital signs were stable. Physical examination showed epigastric tenderness without rebounding pain. A bedside point-of-care ultrasound revealed an intraluminal echogenic lesion that completely obstructed the superior mesenteric vein (Figure 1).