59-Year-Old Man With Abdominal Pain
A 59-year-old man with a past medical history of ischemic stroke, psoriatic arthritis treated with ustekinumab, epilepsy, and left total knee arthroplasty presented with epigastric pain for the past 12 hours. The pain is 10/10 and radiates to the chest and back. He has had several similar episodes in the past year requiring multiple previous hospital admissions. He denies fever, chills, hematemesis, diarrhea, melena, hematochezia, nonsteroidal anti-inflammatory drug use, or alcohol use. Vital signs on presentation show a heart rate of 97 beats/min, blood pressure of 128/82 mm Hg, respiratory rate of 18 breaths/min, temperature of 36.5 °C, and 100% oxygen saturation on room air.