EASTERN VISAYAS REGIONAL MEDICAL CENTER

Brgy.Cabalawan,Tacloban City

CLINICAL ABSTRACT

This is a case of Ognilla,Felix Sr.,82 year old, male,Filipino,Roman Catholic from Carigara ,Leyte
admitted last March 2,2019 for the first time due abdominal pain.
He is a known hypertensive on Metoprolol 100mg taken with good compliance,non-diabetic, a
previous smoker, alcoholic drinker.Known to have gallbladder stones in 2013 advised surgery but
he refused. He underwent E/L from stab wound in 1998 due to stab wound.

Patient was apparently well, until a day PTA, when he complained of abdominal pain localized at
the epigastric area,non-radiating precipitated by intake of guava and following a drinking binge
with tuba.He was brought to Carigara District Hospital assesses as having APN vs AMI,thus
subsequently referred to our center ,hence the admission.

ROS: (-) chest pain,cough,melena,hematemesis,vomiting

Physical examination upon admission showed BP-130/70mmhg,HR-88 bpm,RR-30cpm,O2 sat-
98%,with a note of direct tenderness at the epigastric area.On work up it showed a very
markedly elevated serum amylase, hence admitted as Acute Pancreatitis.Placed on NPO and
given PPI and pain reliever.On the 3rd hospital day, patient was noted to have elevated blood
pressure at 180/100mmhg,HR-98bpm,RR-28,O2 sat-90%,wheezing,tight airways,thus
Hypertensive Emergency vs Acute LV failure was considered- BP control to target with diuretics,
IV Nicardipine and bronchodilator were given.Seen and examined by the General Surgery
service due to abdominal distention since Ileus was observed.The reply was, no surgical
intervention to be done.Thus medical management was maximized.Seen and evaluated also by
the Gastro service with suggestions of starting patient on Itopride,Suppository and electrolytes
monitoring.

On the 4th hospital day,patient was transferred to the semiprivate accommodation and
transferred under my service with Gastro as co mgt.