oa Clinical Quiz

A 52-year-old Qatari woman presented with a four hour history of a severe dull aching upper abdominal pain, repeated vomiting, no hematemesis and no fever or diarrhea. She had not drunk any alcohol. She was known to have hypertension, cardiomyopathy, diabetes mellitus type 2 and hypercholestremia for which she had been prescribed enalapril 20 mg bid, frusemide 20 mg od, digoxin 0.125 mg od, glibenclamide 5 mg od and metformin 500 mg bid.