question | abdominal pain

Thought we’d try something new – putting up a question every now and then to keep you guys sharp. 

For a bigger version of the image, click here

This 74 year old gentleman with a past history significant only for osteoarthritis presents with sharp epigastric abdominal pain. Examination reveals him to be tachycardic and tachypnoeic, with guarding on palpation of the epigastric region. His current medications include paracetamol and ibuprofen. You perform basic bloods and an erect chest X-ray – what is the diagnosis, and what will you do next?

Answer in the comments, or up on Facebook. If you have an interesting clinical case, blood result, or imaging, email us and we’ll put up to test the rest. 

IMAGE: Bill Rhodes


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