Case 5: Introduction

History of Present Illness (HPI)


A 64-year-old obese male presents to the emergency room with 4 days of localized left lower quadrant abdominal pain. The pain had an acute onset and is constant, cramping, and gradually worsening. He also reports having increased and more mushy, non bloody bowel movements (usually 4/day and now 7-8/day) and decreased appetite, though he still tolerates PO. He also endorses chronic unchanged abdominal bloating. This morning, he developed mild, transient nausea and subjective fevers prompting his visit to the ED for evaluation. He endorses unintentional 8lb weight loss in the preceding 6 months.

Past medical history includes hypertension and constipation. No past surgical history. No prior colonoscopies. His medications include lisinopril and occasional tums; denies recent antibiotic use. He is an active smoker with a 20-pack year smoking history. He drinks 2 beers per day and denies a history of intravenous drug use. No recent travel.

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