Presentation consistent with acute epigastric abdominal pain. Differential diagnosis includes ***. Abdominal exam without peritoneal signs. No evidence of acute abdomen at this time. Well appearing. Low suspicion for acute hepatobiliary disease (includng acute cholecystitis), acute pancreatitis, PUD (including perforation), acute infectious processes (pneumonia, hepatitis, pyelonephritis), atypical appendicitis, vascular catastrophe, bowel obstruction or viscus perforation. Presentation not consistent with other acute, emergent causes of abdominal pain at this time.

Plan: labs, UA, GI cocktail, RUQ US ***, serial reassessment

-Courtesy Adam Evans