Abdominal
Pain
Hypotheses
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A
55 year old accountant with acute abdominal pain
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History
A patient is brought to the emergency room with acute abdominal pain. His
ID indicates he is a 55 year old accountant. He appears un-kept with poor body hygiene that
masks any other odour. His abdomen is soft but diffusely tender, distended with ascites;
there are no signs of a localized pain or guarding.
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Laboratory
findings
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high blood alcohol concentration (BAC; 250 mg/dcl), with no
other symptoms of intoxication.
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Patient is febrile, with WBC 17,000; platelets 50k (normal
>150k).
Other findings out of normal
range:
- INR (International Normalized Ratio, a measure of the
state of coagulation) is 3 (normal 1 or below);
- prothrombin
time (PT) is 25 (normal < 13).
- Hepatic enzymes are elevated
(AST > ALT) without cholestatic picture.
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What is the likely reason for the patient's state?
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