Abdominal pain and acid r...

A 71-year-old man presented to the gastroenterology department of the hospital complaining of symptoms of intermittent upper abdominal pain and occasional acid reflux (heartburn). He denied any fever or night sweats but reported unintentional weight loss of about 2 kg within a month. The patient’s symptoms started 1 month prior to the presentation but had worsened over the last 1 week. The patient had a history of intermittent medication for bronchiectasis and bronchitis for more than 30 years, with no known drug allergies. He denied any other history of hypertension, coronary heart disease, and diabetes.

Physical examination

The initial vital sign examination showed normal body temperature (36.4 °C) and regular heart rate (78 beats per min), respiratory rate (18 breaths per min), and blood pressure (118/72 mmHg). Body weight was 73 kg, and height was 168 cm. During the physical examination, a slight tenderness was found under the xiphoid process and upper abdomen. Moreover, there were no palpable lymphadenopathy or mass and no other remarkable findings of positive signs (e.g., McBurney's point tenderness, rebound tenderness and muscle tension, and abnormalities of the cardio-pulmonary system).