Description

W.G. is a 50-year-old male, a new patient complaining of abdominal pain for several months. He has a recent history of black, tarry stool and hematemesis. His past medical history is hyperlipidemia and osteoarthritis. The patient takes an aspirin a day for cardiovascular event prevention. He takes ibuprofen 200 to 400 mg as needed for knee pain. The patient consumes a Western diet, 1-2 cups of coffee daily, and 7 to 10 beers weekly. He is a 30-pack/year smoker. His physical exam is positive for epigastric pain with deep palpation and bowel sounds are hyperactive. His scleras are white. He is negative for hepatosplenomegaly, rebound tenderness, abdominal aorta and renal bruits, and Murphy’s sign. His guaiac test is negative.