Case history and examination.
A 55-year-old lady presented to the emergency department with fever,
epigastric pain and vomiting for one day. She also had 2 bouts of
diarrhea. No [preceding constipation.
She had a background of rheumatoid arthritis which was well managed with
DMARDS including Methotrexate, Sulphasalazine and Upadacitinib. In
addition, she revealed the history of cholecystectomy done 10 years back
for cholelithiasis. She presented to the hospital a month back with
similar symptoms but was managed conservatively
On examination, her vital signs showed pyrexia of 38.7 with normal heart
rate and pulse. She didn’t have any evidence of icterus on examination.
She was tender in the epigastrium.