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Published on: June 29, 2019
A 53-Year-Old Man with Persistent Epigastric Pain
Mohamed Hassan1, Ayman Zaki Azzam1, Rana Abdo1
1The Surgical Oncology, General Surgery, Internal Medicine, and Pathology and Laboratory Medicine Training Programs at the King Faisal Specialist Hospital & Research Center, Alfaisal University, Princess Nourah bint Abdulrahman University, and Alexandria University.
This case report details a 53-year-old man with persistent epigastric pain, unresponsive to proton pump inhibitors. The report illustrates the diagnostic process, refining the differential diagnosis to reach a final conclusion.
Area of Science:
- Internal Medicine
- Clinical Diagnostics
Background:
- Morning Report is a traditional medical education exercise for case-based learning.
- This section aims to replicate the Morning Report experience for a wider audience.
Observation:
- A 53-year-old male presented with chronic epigastric pain, characterized as retrosternal burning.
- Symptoms persisted for months despite empirical treatment with proton pump inhibitors.
Findings:
- The case utilizes a structured approach involving patient history, physical examination, and diagnostic testing.
- An "illness script" was developed to guide the diagnostic reasoning process.
Implications:
- This case highlights the importance of a thorough diagnostic workup for persistent, atypical symptoms.
- It demonstrates the iterative refinement of a differential diagnosis in clinical practice.
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