A 30-year-old female presents with nausea, vomiting, recurring midline abdominal pain especially after eating, fever, and fatty clay-colored stools. She admits to drinking alcohol frequently and also takes ibuprofen for headaches regularly.
- What do you think is the diagnosis?
- How could you find out?
- What tests might you order?
- What other questions might you ask her?
Present your strongest case for diagnosis and list other possible diagnoses that could also explain her symptoms. Consider possible treatment options for your top 2 choices of diagnosis.
This patient presents with a spectrum of symptoms suggesting a gastrointestinal pathology. Nausea, vomiting, and midline abdominal pain are not very specific. Fever suggests an acute inflammatory process or infection. The presence of fatty, clay-colored stools shows that fat is not being digested properly and bile (which provides color to the stool) is not reaching the intestines. Frequent intake of alcohol suggests the possibility of injury from binge drinking. And the frequent use of ibuprofen raises the possibility of a gastric or duodenal ulcer.
In my opinion, the strongest possibility is acute pancreatitis. It fits the patient's clinical presentation perfectly. Acute inflammation of the pancreas can be brought about by chemical injury from irritants such as alcohol. The inflammation induces nausea, vomiting, abdominal pain, and fever. Since the pancreas is unable to function ...
This is a clinical case of a person with recurring abdominal pain, nausea, vomiting, and other symptoms. A broad list of differential diagnoses is discussed and the most likely diagnosis is provided. Important diagnostic tests and treatment options are enumerated.