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A 53-year-old woman presents to an emergency department in London after leaving her workplace due to what she describes as extremely severe and burning pain in her left upper abdomen, radiating to her left back. She explains that she has never experienced these symptoms before, nor has she had any previous acute illness requiring hospitalization.
Her past medical history includes indigestion and regurgitation, which her physician is investigating. Her family history offers no additional relevant information, and findings of a physical examination are unremarkable.
Her vital signs are within normal range, and findings of a general examination are unremarkable. However, palpation of her abdomen reveals a very tender, warm left hypochondrial region with hypersensitivity; there is no evidence of enlarged organs or visible skin lesions.