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 elevated BP. Physical exam is also normal except for peripheral edema and the skin findings below
What is the most likely diagnosis?
- A) AAA
- B) Pancreatitis
- C) Trauma
- D) Cancer
SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT
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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. Lipase was elevated
- C) Trauma – good thought but not injecting insulin
- D) Cancer
1-Minute Consult on this topic: Click HERE and scroll.
CASE CONCLUSION: Lipase mildly elevated at 145 (ULN 60). Repeat was 345. CT showed ascites, but no definite pancreatitis.
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