The pain is usually constant, but it may be intermittent, and it may be made worse by eating. The knee-chest position will usually relieve the pain. Vomiting is aggravated by eating or drinking. It does not relieve the pain. Tenderness may be accompanied by guarding and rebound.
Maximal tenderness is usually in the midepigastric region.
Bowel sounds may be normal, hypoactive, or absent. Upper gastrointestinal hemorrhage. The hemorrhage is thought to result from stress and may originate in the stomach, duodenum, or be caused by penetration of an ulcer into the head of the pancreas. This may be due to a stone in the common bile duct or to edema in the head of the pancreas. A CT of the pancreas often reveals the presence of a boggy, swollen organ.