A 39-year-old Man with Abdominal Pain

摘要

A 39-year-old, single, unemployed black male named AG, presents with a chief complaint of "I need my pancreas removed."AG initially presented with complaints of abdominal pain. Collateral information from an adult foster care home manager revealed that the patient had been sleeping poorly, had been refusing mediations, had been increasingly suspicious and isolative, had not been bathing, and had been accusing staff of tampering with his food.Upon transfer to an inpatient psychiatric unit, he was found to be subdued but urgently requests surgical evaluation for "my pancreatitis." He reported daily episodes abdominal pain associated with poor appetite. He related that the pain had not changed in quality for 8 years, at which point he was diagnosed with new-onset diabetes. He said that his pancreas was "scattering" his thoughts and explained that his pancreas needed to be removed to cure him.