The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 21-year-old man presents to the emergency department with a 10-hour history of epigastric pain that is radiating to his chest. The pain is constant, localized, and sharp in nature.
He was at what he describes as a "wild party" the previous night. He states that he drank alcoholic beverages but did not use any illicit drugs. He has no associated nausea, vomiting, or indigestion. He has not experienced this pain in the past. The patient provides no history of shortness of breath, palpitations, or syncope. He has no history of trauma to the epigastrium. He does not remember anything that may be causing his symptoms but states that his memories of the night are hazy.
His past medical history is significant for an appendectomy 9 years ago and surgery for a deviated nasal septum 11 months ago. He is not currently on any regular medication. He has no history of allergies. His family history is negative for any cardiac or abdominal pathology. He smokes approximately 1 pack of cigarettes a day and binge-drinks alcohol at weekend parties.
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Cite this: Abraham A. Ayantunde, George G. Araklitis. A 21-Year-Old Man With Epigastric Pain After a Wild Party - Medscape - Dec 14, 2022.