An 18-Year-Old With Nausea and Increased Abdominal Girth

Michel E. Rivlin, MD

Disclosures

January 26, 2016

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 that you would like to suggest for a future Case Challenge, please contact us.

Background

An 18-year-old white woman presents to the clinic with a 2-month history of generalized abdominal pain, nausea, decreased appetite, and increased abdominal girth. She is not exhibiting any abnormal urinary or bowel symptoms, but she does complain of an intermittent, low-grade fever that is sometimes accompanied by chills. A review of her past medical, surgical, and family histories is insignificant.

Her menstrual history reveals regular cycles. She is nulligravid but is sexually active and is not currently using any contraception. She has no known allergies and does not regularly take any medications.

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