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.
A 33-year-old man with a history of an exploratory laparotomy and small bowel resection for a motor vehicle accident 4 years ago presents to the emergency department complaining of nausea and vomiting. He is found to have a high-grade small-bowel obstruction and undergoes an exploratory laparotomy and lysis of adhesions. He tolerates the procedure well and is transferred to the floor postoperatively.
On postoperative Day 1, he is extubated, the nasogastric tube is removed, and he is started on heparin 5000 U (3 times daily). On postoperative Day 2, he is started on a clear liquid diet and begins to ambulate with the help of the nursing staff. On postoperative Day 3, the patient starts to complain of chest pain and shortness of breath.
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Cite this: Jason Chang, Linda Chun. Chest Pain and Shortness of Breath in a 33-Year-Old Man - Medscape - Jul 20, 2020.