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A 50 year old male with epigastric pain

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  This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.” This is a case of a 50 year old male with complaints of fever since 5 days and epigastric pain since 4 days  History of Presenting Illness Patient was apparently asymptomatic 5 days ago. Then he developed fever. It lasted for a day and was associated with chills and rigours and subsided with antipyretics. Then later in the evening he developed epigastric pain after the fever subsided. Pain is in the epigastric and right hypochondriac region primarily, gradually progr