A 53-Year-Old Man with Persistent Epigastric Pain.

NEJM evidence Pub Date : 2024-11-01 Epub Date: 2024-10-22 DOI:10.1056/EVIDmr2400027
Mohamed Hassan, Ayman Zaki Azzam, Rana Abdo, Abdulmajid Alomran, Zoha Alghamdi, Rania Naguib, Khaled O Alsaad, Tarek M Amin
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Abstract

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 53-year-old man who had epigastric pain that he described as a sensation of burning behind his sternum. It persisted for months despite treatment with proton pump inhibitors. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.

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一名 53 岁男性的持续性上腹痛。
摘要 "晨间报告 "是一个历史悠久的传统,由受训医师向同事和临床专家介绍病例,共同研究有趣的患者表现。晨间报告 "部分旨在继承这一传统,通过介绍患者的主要病症和故事,邀请读者与病例作者一起进行鉴别诊断并发现诊断结果。本报告探讨的是一名 53 岁男子的上腹部疼痛故事,他将疼痛描述为胸骨后烧灼感。尽管使用质子泵抑制剂进行了治疗,但疼痛仍持续了数月。通过提问、体格检查和化验,该病例出现了疾病脚本。随着临床病程的进展,鉴别诊断也在不断完善,直至确诊。
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