A 22-year-old woman presented with a 4-month history of intermittent abdominal pain. In the weeks before presentation, the pain worsened, became constant, and exacerbated by movement or eating. The pain localized to her right upper quadrant and radiated to the epigastric region. She had associated nausea and occasional nonbloody emesis. In addition, she noted early satiety and weight loss of approximately 30 pounds in the 3 months before admission. She denied fever, chills, night sweats, constipation, diarrhea, melena, or hematochezia. The patient had a history of depression and hemorrhoid-ectomy. She took no medications and had no known allergies. She lived with her fiance. She smoked a half pack of cigarettes daily and drank alcohol in social settings. She denied illicit substance use. Her maternal grandmother had gastric cancer and a maternal uncle had leukemia.
展开▼
