Left-sided Abdominal Pain in a 45-yr-old Man

Past Medical History

  • Medical history: Diabetes mellitus since his 20s that is well-controlled with oral drugs, diet, and exercise. Hypertension and hyperlipidemia both well-controlled on drugs. Obstructive sleep apnea for which he uses a CPAP machine. Recent deep venous thrombosis that developed after a long international flight and that is currently being treated with an oral anticoagulant. Denies history of UTIs, difficulty with urination, COPD, renal stones, and immunosuppressive disorders.

  • Surgical history: Wisdom tooth extraction as a teenager; no abdominal surgical procedures.

  • Medications: Lisinopril 10 mg daily, aspirin 81 mg daily, rosuvastatin 10 mg daily, rivaroxaban 20 mg daily, metformin 850 mg daily, and niacin 1 g daily.

  • Allergies: No known drug allergies.

  • Family history: Mother and father have hypertension; sibling has history of kidney stones.

  • Social history: He denies current and previous tobacco use. He works at a desk job and swims laps at his local pool several times a week. All immunizations are up-to-date. He denies exposure to any sick contacts. For the past 15 yr, he has had unprotected sex only with his wife.