Saturday, January 17, 2009

What Next...

22 year old male, previously fit and well, presents at 4 in the morning. The previous evening he had had a curry, but nothing unusual. A few hours later he had begun to feel unwell.
He described epigastric pain, associated with nausea and vomiting. He had had no change in bowel habit, and there was no blood or bile in the vomitus.

He had had no recent foreign travel, denied drug ingestion, and none of his friends were unwell.

He was afebrile, warm at the edges and cardiovascularly normal, and stable.

Abdominal exam was untirely normal, routine blood tests and radiographs were normal.

As his pain had required opiate analgaesia, he was boarded on our obs ward for several hours.

Repeat exam some four or five hours later remained normal. His observations had been stable, and his pain had settled. He felt better.

Can I send him home?

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