Case 4-2014: A 39-year-old man with night sweats and abdominal pain

摘要

The patient had been well until 1 week before admission, when night sweats developed, which he attributed to the summer heat. Three days before admission, episodes of sharp abdominal pain developed; the pain was greatest at the costal margin on the right side, and the patient rated it at up to 7 on a scale of 0 to 10 (with 10 indicating the most severe pain). The pain lasted up to 2.5 hours, increased with deep breaths, was worse 1 to 2 hours after meals, and was associated with mild nausea, belching, hiccups, bloating, and loose, gray stools. The symptoms did not improve with simethicone or ibuprofen. On the day of admission, the pain recurred with increased severity, and the patient came to the emergency department at this hospital.