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A 37 Year old with chief complaints of abdominal pain.

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 A 38 yr old male with chief complaints of abdominal pain.  CASE A 38 year old male came to OPD with chief complaints of abdominal pain since 4days. HOPI Patient  was apparently asymptomatic  4 days ago, then he developed epigastric pain insidious in onset ,continuous, stabbing pain,radiating to back,aggrevated on eating food,relived on bending forward associated with vomitings(10episodes per day which is non-bilious, non-projectile,non blood tinged,content-food material). H/O constipation  since 4 days. H/O bloating  since 4 days. PAST HISTORY   No similar complaints  in the past.  Not a known case of diabetes mellitus, hypertension,  thyroid,  epilepsy.  No history of previous surgeries.  PERSONAL HISTORY  DIET : mixed APPETITE : decreased  SLEEP : adequate  BOWEL : constipation  MICTURITION :no urine output  FAMILY HISTORY  Not relevant  GENERAL EXAMINATION  PALLOR : Absent ICTERUS : Absent  CYANOSIS : absent CLUBBING : Absent LYMPHADENOPATHY : Absent EDEMA : Absent VITALS TEMPERATU