A 55-year-old woman presented with a 1-month history of intermittent, burning epigastric abdominal pain that was moderately severe in intensity. Her pain radiated toward her back in a band-like fashion. She also noted nausea and vomited once, with the vomit consisting of food particles. The patient denied having signs and symptoms of melena, hematochezia, or hematemesis. PMH: Her medical history was significant for peptic ulcer disease, and the patient had had multiple endoscopies in the past 6 years.
It was learned that she had 2 clean-based antral ulcers 5 years prior (Fig. 1) and was started on lansoprazole, which she could not afford and so was switched to omeprazole, which she used intermittently. She also admitted to past use of an over-the- counter analgesic consisting of acetaminophen, aspirin, and caffeine. Physical Examination: On examination, the patient’s abdomen was soft…
