Case Report
A 45-year-old man presented to the emergency department with four
episodes of vomiting of ingested food. It is non bilious, non-projectile
and does not contain blood. He has periumbilical non-radiating abdominal
pain with gradual onset of 3 days duration. He was previously diagnosed
with mild duodenitis via endoscopy, for which he had initiated treatment
with oral Esomeprazole 40mg per day for a month. The patient’s medical
history was otherwise not noteworthy. His family history was
noncontributory. He occasionally drinks 2 units of alcohol but has no
history of drug use or smoking.
On admission, he had a body temperature 36.4 °C, a blood pressure of
120/80 mmHg, a respiratory rate of 16 breaths/min, a heart rate of72
beats/min, and an oxygen saturation of 95% of room air. On physical
examination, we noticed the patient had dry mucosa and mild epigastric
tenderness. His cardiovascular and respiratory examinations were normal.
Results of his abdominal examination was normal and he had no
lower-extremity edema. A summary of his laboratory investigations are
reported in Table 1. A baseline ECG was obtained, which showed a normal
sinus rhythm with non-ischemic changes. His cardiac troponin T levels
was initially 2.8ng/dL.