A 44-Year-Old Man With Abdominal Pain, Lung Nodules, and Hemoperitoneum (original) (raw)
A 44-year-old man presented with a 1-day history of sudden-onset abdominal pain. The pain was characterized as severe, diff use, sharp, and nonradiating. Associated symptoms included nausea, vomiting, diarrhea, and subjective fevers. He was originally from El Salvador, but had not traveled in. 10 years. Review of systems was positive for 2 weeks of dry cough with associated mild, bilateral, pleuritic chest pain and subjective weight loss. His medical history was notable for gout and end-stage renal disease secondary to chronic nonsteroidal antiinfl ammatory drug use, for which he attended hemodialysis sessions three times weekly. Surgical history consisted of a currently nonfunctioning left upper extremity fi stula, a longstanding right internal jugular PermCath IV access for chronic hemodialysis that had been removed 2 weeks prior to presentation, and a left brachiocephalic fi stula. He did not smoke, consume alcohol, or have a history of illicit drug use.
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