ABSTRACT
History A 45-year-old man presented to the acute medical unit with a 48-hour history of gradual onset epigastric pain. He described this as ‘gnawing’ in nature and radiating through to the back. It was associated with vomiting and nausea, while coming and going in waves. The pain was made worse following a meal with partial relief on leaning forward. He described the severity as 8 out of 10.
