History of Present Illness: A 60-ish-year-old female with a history of ESRD on HD and HTN but no DM presents with 1 day of left lower quadrant bruising noted at 6 AM along with generalized abdominal pain and distention. She has nausea but no vomiting or fever. No history of same. No trauma. No other complaints.
Vital Signs & Physical Exam: Vital signs are normal except for mildly elevated BP. Physical exam is also normal except for peripheral edema and the skin findings below. There is minimal abdominal tenderness as well.
What is the most likely diagnosis?
- A) AAA
- B) Pancreatitis
- C) Trauma
- D) Cancer
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QUIZ ANSWER: What is the most likely diagnosis?
- A) AAA – good thought but more likely to cause flank ecchymosis (Grey-Turner sign)
- B) Pancreatitis – CORRECT – Cullen’s sign from hemorrhagic pancreatitis
- C) Trauma – good thought but not injecting insulin
- D) Cancer
1-Minute Consult on this topic: Click HERE and scroll.
CASE CONCLUSION: Lipase elevated at about 6 times ULN. CT showed ascites, but and pancreatitis.