Vignette 20

    Admission Notes:

    17-year-old girl presents with abdominal pain, pain in left shoulder and left chest, breathing difficulty and nausea. Began to vomit and get faint at home. Her mother looked at stomach and saw extensive bruising. Reports that daughter admitted she had been punching herself in the stomach.

    Behavior: Frightened and crying. Seems very anxious. Keeps saying “I’m sorry”.