Case Study - monday 12092016Created by:
A middle aged gentleman, with background history increased body mass index, hypertension, type 2 diabetes, smoker, oestoarthritis, presented to casualty due to severe epigastric pain with few episodes of vomiting in the afternoon. Patient was very unwell when attending casualty, and was seem to be in severe abdominal pain. Patient was not drinking any alcohol for the last week, and deny any haematemesis. On examiantion showed patient has severe upper abdominal pain.He had low blood pressure of 85/65, arterial blood gas show acidosis (pH 7.21), high lactate of 5. Fulll blood count showed that his Haemoglobullin (Hb) was around 11.0. Normal amylase level. Cardiac investigation (ECG, troponin) was negative. What is your differential diagnosi ? What is your managment plan ?