Abdominal Pain After Vomiting

Author: Amanda Parker / Editor: Jason Lee / Reviewer: Nadarajah Prasanna, Sarah Hickin-Yacoub / Codes: / Published: 01/04/2022

A 75-year-old man presented to the Emergency Department (ED) of a District General hospital complaining of severe abdominal pain that followed an episode of vomiting earlier in the day. He also reported one episode of loose stool that morning.

His past medical history included ischaemic heart disease, coronary artery bypass grafting and a permanent pacemaker.

On examination he was clammy, with poor air entry at both bases. No wheezes, crepitations or murmers were heard. He was tender in his epigastrium and his abdomen was rigid. Bowel sounds were absent.

His observations were as follows:

  • Pulse 140 (AF) beats per minute
  • BP 125/75 mmHg
  • Respiratory rate 30 per minute
  • O2 saturations 89% on air

An AP semi-erect chest radiograph was requested:


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