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A previously fit 30-year old software technician was admitted with a 2-week history of severe abdominal pain, associated with nausea and bloody diarrhoea. He had no medical or surgical history, was a non-smoker and took no medication or recreational drugs. His mother, brother and maternal grandmother had had deep vein thromboses or pulmonary emboli.
On examination he was afebrile, with central abdominal tenderness but no evidence of peritonism. His white cell count (16.1×109/litre) and C-reactive protein (CRP, 138 mg/litre) were elevated. Serum amylase and lactate were normal.
Chest and plain …
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