My patient is a 47 year-old white female with recurring, intermittent left upper quadrant abdominal pain, nausea, emesis fever and diarrhea that becomes incapacitating.
Episodes occur every few months, requiring hospitalization.
Occasional urinary tract infections have accompanied the pain, but not consistently. EGD, ultrasound, stool cultures, colonoscopy, CT of the abdomen and blood cultures have been negative. Left upper quadrant tenderness is present during episodes. She has been seen by a gastroenterologist, a surgeon, an ID specialist and an anesthesiologist well-versed in neuropathic pain syndromes. No definitive etiology has been identified.