title: Clinical Case Of the Month: A 35 Year Old Woman with Abdominal Pain.
abstract: A 35 year old woman with past medical history of hypertension presented to the emergency department with chief complaint of severe abdominal pain for one week. The abdominal pain was located in the epigastrium and described as "cramping" and "intermittent". The pain intensity was quantified initially as 6 out of 10 on the pain scale. As the week progressed the pain became constant and radiated to the back. The intensity of the abdominal pain increased to 10 out of 10. The patient reported some relief from her pain while lying in the prone position. Initially the pain was associated with loose stools for several days. The loose stools resolved spontaneously and then the patient began to experience nausea and vomiting. Her medications included lisinopril-hydrochlorothiazide which she had been taking for the past five months. She had no history of alcohol, tobacco or illicit drug use.
authors.affiliation: House officer in the Internal Medicine Residency in the Department of Medicine at the Louisiana State University Health Sciences Center in New Orleans, LA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Spera
authors.affiliation: Gastroenterology fellow at Tulane University Health Sciences Center in New Orleans, LA.
authors.forename: Camille
authors.initials: C
authors.lastname: Thelin
authors.affiliation: House officer in the Internal Medicine Residency in the Department of Medicine at the Louisiana State University Health Sciences Center in New Orleans.
authors.forename: Abby
authors.initials: A
authors.lastname: Gandolfi
authors.affiliation: House Officer in the Radiology residency program at the University of Alabama at Birmingham.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Clayton
authors.affiliation: Assistant Professor in the Department of Radiology at Louisiana State University Health Sciences Center in New Orleans, LA.
authors.forename: Karl M
authors.initials: KM
authors.lastname: Nettles
authors.affiliation: Vice Chair for Research and Professor in the Department of Medicine at LSUHSC in New Orleans, LA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hagensee
authors.affiliation: Medical Director of Endoscopy at University Medical Center in New Orleans, LA.|Associate Professor in the Departments of Internal Medicine, Psychiatry, and Family Medicine at the Louisiana State University Health Sciences Center in New Orleans.
authors.forename: John J
authors.initials: JJ
authors.lastname: Hutchings
authors.affiliation: Richard Vial Professor and Vice Chair for Education in the Department of Medicine at Louisiana State University Health Sciences Center in New Orleans, LA.
authors.forename: Fred
authors.initials: F
authors.lastname: Lopez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D004322:Drainage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension; D017706:Lisinopril / Q000627:therapeutic use*; D010147:Pain Measurement; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging* / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D004338:Drug Combinations; C091365:hydrochlorothiazide, lisinopril drug combination; D006852:Hydrochlorothiazide; D017706:Lisinopril