A patient with abdominal pain
A previously fit and well 36 year old woman presented at the emergency department with a three week history of sudden onset severe abdominal pain and vomiting. The pain settled and she was discharged with proton pump inhibitors. However, a week later she continued to feel unwell and was seen by her on-call general practitioner.
She complained of a continuing feeling of left hypochrondrial abdominal pain that did not radiate and generally feeling unwell. She had no associated symptoms of nausea or vomiting, weight loss or anorexia. The pain was not relieved on rest and there was no relation to food. She did not smoke and drank on average 4-5 units of alcohol a month. There were no other aggravating or relieving factors. She was not taking any drugs and had no noteworthy previous medical or family history. For contraception, she had had a depot injection two months before.