Shortness of Breath and Abdominal Pain in an Obese Woman

Andrew E. Green, MD

Disclosures

January 16, 2018

Editor's Note: The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.

Background

A 52-year-old obese white woman (gravida 2, para 2) presents to the emergency department with shortness of breath and crampy abdominal pain. She was seen 3 weeks ago by her family practitioner for similar pain. Her examination findings were normal at that time, per her report. She was referred to a gastroenterologist. From that appointment, she reports normal examination findings. She had a screening colonoscopy 1 week ago and reports no issues; she has not had her follow-up appointment.

Upon further questioning, she reports that her appetite is decreased and that she has been experiencing early satiety for the past 1-2 weeks. She reports having normal bowel movements and urinary habits. She has a medical history of hypercholesterolemia and mild hypertension. She had a screen for diabetes last year that was negative. She has a surgical history of a laparoscopic cholecystectomy and a hysterectomy. She takes metoprolol and atorvastatin. She has no known allergies. She reports no smoking, drinking, or illicit drug use. She has a family history of hypertension and breast cancer.

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