An elderly woman with a history of coronary bypass comes in with severe, diffuse, abdominal pain. strangely, during your examination, the pain is not made worse by pressing on the abdomen. what do you suspect?
Ischemia is suspected in
this case. If there’s history of bypass, it can be used as a clue to see if
there is vascular narrowing elsewhere. Malingering is unlikely. However,
neuropathic pain as seen in herpes zoster, would get worse with touch.
