A 77-year-old man presents in the early morning with a 4-hour history of severe, generalized abdominal pain . He describes having had some cramplike abdominal pain and bilious vomiting yesterday, but states that he simply "got on with things." Case presentation His condition had worsened considerably by late evening. He describes the sudden onset of generalized, constant, intense abdominal pain necessitating an ambulance call. On presentation to the emergency department, the patient has no current vomiting.
He describes episodic "indigestion" that has occurred off and on for the past few months. On further questioning, the patient reports experiencing infrequent but quite painful episodes of upper abdominal pain after meals , which sometimes feels as if it is "going to his right upper back" and is associated with intermittent vomiting . This lasts for minutes to hours after the intake…
