A 44-year-old man with abdominal pain, lung nodules, and hemoperitoneum.
A 44-year-old man presented with a 1-day history of sudden-onset abdominal pain. The pain was characterized as severe, diffuse, sharp, and nonradiating. Associated symptoms included nausea, vomiting, diarrhea, and subjective fevers. He was originally from El Salvador, but had not traveled in &gt; 10 years. Review of systems was positive for 2 weeks of dry cough with associated mild, bilateral, pleuritic chest pain and subjective weight loss. His medical history was notable for gout and end-stage renal disease secondary to chronic nonsteroidal antiinflammatory drug use, for which he attended hemodialysis sessions three times weekly. Surgical history consisted of a currently nonfunctioning left upper extremity fistula, a longstanding right internal jugular PermCath IV access for chronic hemodialysis that had been removed 2 weeks prior to presentation, and a left brachiocephalic fistula. He did not smoke, consume alcohol, or have a history of illicit drug use.
Department of Medicine, Division of Pulmonary and Critical Care Medicine, UCLA-Olive View Medical Center, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
Mariam
M
Mostafavi
Department of Medicine, Division of Pulmonary and Critical Care Medicine, UCLA-Olive View Medical Center, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA. Electronic address: kamangar@ucla.edu.
Nader
N
Kamangar
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000785:Aneurysm, Infected / Q000150:complications / Q000175:diagnosis*; D055499:Catheter-Related Infections / Q000150:complications / Q000175:diagnosis*; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis*; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D008943:Mitral Valve; D055613:Multiple Pulmonary Nodules / Q000209:etiology; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*