[42M] Experiencing severe upper abdominal and back pain with vomiting

Patient Description

A 42-year-old male presents with sudden onset of severe, sharp, stabbing pain in the upper abdomen and back, which started yesterday afternoon. The pain is described as radiating from the stomach to the upper back near the shoulder blades and is exacerbated by sitting, standing, and attempting to walk. The patient rates the pain as a 10 on the severity scale. Accompanying symptoms include vomiting once with ongoing nausea, fever, chills, and lightheadedness. The patient's last bowel movement was yesterday, described as liquid in consistency. There is no reported yellowing of the skin or eyes, no specific food triggers for vomiting, and no changes in stool color. The patient has no known allergies, is not currently on any medications, and has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Acute Pancreatitis: This condition is characterized by sudden inflammation of the pancreas, which can cause severe upper abdominal pain that radiates to the back, nausea, and vomiting. Fever and a rapid pulse are also common symptoms. This condition can be life-threatening and requires immediate medical attention.

    • Treatment typically involves hospitalization, fasting to rest the pancreas, pain management, and IV fluids. In some cases, surgery may be necessary.

  • Gallstones: These are hard deposits in the gallbladder that can cause a sudden and rapidly intensifying pain in the upper right portion of your abdomen, the center of your abdomen, or the upper back between your shoulder blades. Nausea and vomiting are common symptoms.

    • Treatment can range from watchful waiting for asymptomatic stones to surgery for symptomatic stones.

  • Peptic Ulcer: This is a sore on the lining of your stomach, small intestine, or esophagus. Peptic ulcers can cause dull or burning abdominal pain, nausea, vomiting, bloating, and a feeling of fullness.

    • Treatment typically involves medication to decrease stomach acid. If an ulcer is caused by a bacterial infection, antibiotics may be prescribed.

Remember, I'm an AI and not a doctor. These are just possibilities based on the symptoms you've shared. It's important to seek immediate medical attention to get a proper diagnosis and treatment.

What you can do

Given the severity of your symptoms, you should seek immediate medical attention. Call an ambulance or have someone drive you to the emergency department.

What you should look out for

Please monitor your symptoms closely and seek immediate medical attention if:

  • Your pain becomes more severe or spreads to other areas
  • You develop a high fever
  • You experience repeated vomiting
  • You notice a change in the color of your stool or urine
  • You become increasingly lightheaded or faint
  • Your heart rate increases or you have difficulty breathing

Again, please seek immediate medical attention. Your symptoms are severe and could indicate a serious condition.

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11 mo ago

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People Also Ask

What are the common symptoms of acute pancreatitis?

Common symptoms of acute pancreatitis include sudden severe upper abdominal pain that may radiate to the back, nausea, vomiting, fever, and a rapid pulse. The pain often worsens after eating.

How are gallstones typically treated?

Gallstones are typically treated based on the severity of symptoms. Asymptomatic gallstones may not require treatment, while symptomatic gallstones often require surgical removal of the gallbladder (cholecystectomy). In some cases, medications to dissolve gallstones or procedures to break them up may be used.

What are the potential complications of a peptic ulcer?

Potential complications of a peptic ulcer include bleeding, perforation (a hole in the wall of the stomach or intestine), and gastric outlet obstruction (blockage of food leaving the stomach). These complications can be serious and require medical attention.

When should someone with severe abdominal pain seek immediate medical attention?

Immediate medical attention should be sought if someone experiences severe abdominal pain that is sudden and intense, especially if it is accompanied by symptoms like fever, repeated vomiting, lightheadedness, changes in stool or urine color, or difficulty breathing. These could indicate a serious condition requiring urgent care.

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