Long Case Y3B3

Interesting case. History was suggestive of a foregut lesion, but none from biliary colic/duodenal ulcer/repetitive acute pancreatitis could have been ruled out. Epigastric pain, worsened by food, dull/burning in nature, repeated exacerbations since 2003; OGDS done 4 times. Examination revealed that the patient was pink, and there was only superficial tenderness from the right lumbar all the way to the left hypochondrium.

OGDS revealed just a hiatal hernia with Barrett's esophagus; completely nothing else related at all to the clinical presentation. In the end the discussion was mainly about mismanagement, as there were no investigations related to the liver/pancreas at all. The exam discussion led to some changes to the actual management of the patient (to have LFT's and serum amylase actually taken).