A Window of Opportunity

doi:10.1056/NEJMcps031315

Volume 349:1848-1853		November 6, 2003		Number 19

A Window of Opportunity

Sandra J. Bliss, M.D., Richard H. Moseley, M.D., John Del Valle, M.D., and Sanjay Saint, M.D., M.P.H.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In this Journal feature, information about a real patient ispresented in stages (boldface type) to expert clinicians fromseveral specialties, who respond to the information, sharingtheir reasoning with the reader (regular type). The authors'commentary follows.

A 62-year-old woman presented to her local emergency departmentbecause of pain in the epigastrium and right upper quadrant.The pain had begun insidiously five days earlier and was constant,severe, and exacerbated by deep inspiration. She also reportedhaving anorexia, nausea, fatigue, night sweats, and chills,but not fever, vomiting, diarrhea, melena, hematochezia, jaundice,or weight loss.

Several features of the . . . [Full Text of this Article]

Commentary

Source Information

From the Departments of Internal Medicine (S.J.B., R.H.M., J.D.V., S.S.), and Pediatrics (S.J.B.), University of Michigan; the Patient Safety Enhancement Program, Ann Arbor Veterans Affairs Medical Center and University of Michigan Health System (S.S.); the Medical Service, Ann Arbor Veterans Affairs Medical Center (R.H.M.); and the Ann Arbor Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) — all in Ann Arbor, Mich.

Address reprint requests to Dr. Bliss at the University of Michigan Health System, Canton Health Center, 1051 N. Canton Center Rd., Canton , MI 48187, or at sbliss@umich.edu.