TY - JOUR T1 - Epigastric pain: a life-threatening condition JF - Emergency Medicine Journal JO - Emerg Med J SP - 829 LP - 830 DO - 10.1136/emermed-2015-205640 VL - 33 IS - 11 AU - Ashish Chawla AU - Pratik Mukherjee AU - Dinesh Singh Y1 - 2016/11/01 UR - http://emj.bmj.com/content/33/11/829.abstract N2 - An 82-year-old woman presented to the ED with complaint of severe epigastric pain since last 2 days. The pain was progressive in severity and associated with vomiting. Physical examination revealed mild epigastric tenderness and bibasilar crepitations while the ECG was unremarkable. Laboratory tests were within normal range. A frontal chest radiograph was obtained (figure 1).Figure 1 Frontal chest radiograph.Which organ is the most probable cause of epigastric pain, based on the radiographic findings? Lung and pleuraRibsThymusStomachThe frontal chest radiograph (figure 2) shows a large opacity in the retrocardiac region with an air–fluid level. The borders of the opacity extend beyond the cardiac shadow. These findings are suggestive of herniation … ER -