omarMDramo Emergency Medicine --- # Case Summary ## Presentation 31 YOM W/ no PMH, h/o Meth use by smoking it C/O diffuse abdominal pain that gradually started one hr prior to this ED visit and denies fever, chest pain, SOB, N/V/D/C, back pain, dysuria or any other associated sxs. His last meth use was two days prior to this ED visit. Any thoughts? --- ## Images --- ## Similar Cases - [21 female presents c/o SoB w/ chest pain upon inspiration/expiration and movement. No prior hx. Any ideas?](https://app.figure1.com/case-detail/333afd0e-9fb1-458f-a4ca-7b3434a5cef5) - [54 y/o female complaining of upper shoulder/rib pain. No prior scopes or abdominal surgeries. Or prior imaging. Me and my coworkers are debating on cause and I'm going with gastric ulcer perforation/possibly duodenal ulcer perf. Only way I can think of that causes this much free air with no other predisposing factors.](https://app.figure1.com/case-detail/3da69f7d-796f-4ede-9ca0-90c4e0037784) - [25 yr.old male.c/o severe epigastric and right hypochondriac pain . tenderness.radiating to both shoulders.also c/o difficulty in breathing.pain increases on deep breathing](https://app.figure1.com/case-detail/5df6cf72-4b39-4006-b139-492105b4542d) - [EMS dispatched to a 54 y/o complaint of right sided thoracic pain. Seen earlier that day at the ED for same complaint and discharged home with antibiotics and opioids for possible pneumonia. A few hours later calls EMS due to acute onset of dark colored emesis. States 3+ episodes of vomiting prior to our arrival. 150mL of emesis while with EMS. Daily oral intake includes toast and glass of water. Pale/diaphoretic, 88 HR, 138/82. No abdominal pain, tenderness, dissension, rigidity. PMH right lung mass with thoracoscopy. No anti-coagulant use.](https://app.figure1.com/case-detail/62e92cfd-2cb3-461e-956e-cf284e8a687e) --- ## Additional Notable Cases - [A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a) - [A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5) - [A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de) - [Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history.](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)