Abdomen

A 57-year-old male presents with progressively worsening epigastric pain.  Shortly after dinner he felt a sharp pain in his epigastric region. He is tachycardic and tachypneic and appears in distress with diaphoresis. Abdominal exam shows diffuse tenderness with guarding. What should you consider?

Abdominal pain is common; so are strongly held myths and legends about what is concerning, and what is not. One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Morbidity and mortality varies by age and condition.