2018
DOI: 10.1053/j.gastro.2017.08.021
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An Unusual Cause of Severe Epigastric Pain

Abstract: Question: A 47-year-old man with an unremarkable medical history presented to our emergency department with severe epigastric pain. He reported eating raw chub mackerel pieces (sashimi) 7 hours before symptom onset. His vital signs were stable and his body temperature was 36.9 C. He had no abdominal tenderness despite severe spontaneous pain. Laboratory findings revealed an elevated white blood cell count (13.8 Â 10 3 /mL) and C-reactive protein concentration (1.03 mg/dL). No ischemic change was detected on an… Show more

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