title: [Acute abdominal pain of difficult diagnosis: Report of one case and reflections about evidence based medicine].
abstract: Evidence based medicine is strongly positioned in medical practice. However we must remember that it should be just a part of our knowledge and skills and that a close relationship with our patients is essential. I report a 52 years old male that presented with abdominal pain in the right upper quadrant lasting seven days, that started after participating in a celebration dinner. Abdominal ultrasound was normal and biochemical tests were within normal limits. An upper gastrointestinal endoscopy showed a toothpick that was perforating the gastric wall. The toothpick was withdrawn and the pain subsided. The patient was discharged asymptomatic three days later.
authors.affiliation: Escuela de Medicina, Universidad de Valparaíso, Servicio de Medicina, Hospital Naval Almirante Nef, Viña del Mar, Chile. jduclos@vtr.net
authors.forename: Jaime
authors.initials: J
authors.lastname: Duclos H
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D019317:Evidence-Based Medicine; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged