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A case of HGV-related epigastric pain
  1. C A Wadsworth1,
  2. P Ziprin2,
  3. M X Pelling3,
  4. L R Jiao2,
  5. M R Thursz1
  1. 1Department of Hepatology and Gastroenterology, Imperial College London, London, UK
  2. 2Department of Surgery, Imperial College London, UK
  3. 3Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Prof Mark R Thursz, Hepatology Unit, 10th Floor QEQM Building, St Mary's Hospital, Praed Street, London W2 1NY, UK; m.thursz{at}

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A 58-year-old man presented to our unit with intermittent epigastric pain that had developed since his involvement in a road traffic collision (RTC) 5 weeks earlier. The patient had been driving, and wearing a seatbelt, when his car collided head-on with a heavy goods vehicle (HGV). Apart from a fractured radius, sustained in the RTC, he was fit and well.

The patient appeared well. Aside from minimal tenderness of the epigastrium, physical examination was unremarkable. The following laboratory indices were abnormal; C-reactive protein 20 mg/l (0–5); haemoglobin 11.1 g/dl (13.4–16.6); amylase 295 U/l (0–90) and alkaline phosphatase (ALP) 226 U/l (30–130). A multidetector CT (MDCT) scan of the abdomen was undertaken …

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