Patient History: A 21-year-old female presents to the Emergency Department with a 3-hour history of epigastric and right-upper abdominal pain associated with nausea and vomiting. She denies any history of similar episodes in the past and had no complaints of chest pain, fever or shortness of breath, frequency or dysuria. The patient denies sick contacts, although she did have a recent upper respiratory infection for which she was given antibiotics. Physical Examination: Temperature 98.9°F HR: 94 bpm RR: 20 breaths per minute BP: 136/98 mm Hg General: Age appropriate, anxious patient with a flat affect in moderate discomfort. Pulmonary: Clear to auscultation CV: Regular rate and rhythm without murmur.
Abdomen: Normal bowel sounds. Tenderness in the epigastrium and right upper quadrant with guarding. Rectal: Rectal exam was non-tender and guaiac negative. What laboratory studies and…
