Case Study #3 Ms Hampton is a 55-year-old female who presents to the emergency d

Case Study #3
Ms Hampton is a 55-year-old female who presents to the emergency department with crampy epigastric pain that woke her up in the middle of the night. She has had similar attacks over the past several months that generally last for 3 to 4 hours. Heavy meals worsen the pain. She denies nausea and vomiting, has normal bowel movements, no fever or chills, and no hematuria, dysuria, or chest pain. Patient medical history is remarkable for type 2 DM, HTN, and atrial fibrillation. Medications include metoprolol, insulin, and aspirin; she occasionally takes acetaminophen for knee pain. She reports no alcohol use. On physical examination vitals are normal. The patient is afebrile. Sclera is nonicteric. Cardiac and lung examinations are normal except for the presence of an irregularly irregular cardiac rhythm. Abdominal examination shows a slightly obese abdomen. Bowel sounds are present. Abdomen is soft, with mild epigastric tenderness present. No guarding or rigidity is present. Murphy sign is negative. Rectal examination is normal. Stool is Hemoccult negative.