A 35-year-old school teacher presents himself to ER staff at the Foothills Hospital complaining of abdominal pain. Upon taking the his history, the patient reveals that he has had similar bouts of abdominal pain since he was a university student, but these were uncommon and he would often not have them for years at a time. This most recent attack of abdominal pain began 4 months ago, following an 8 year period of no such pain. The pain consists of intermittent spasms in the upper quadrant that can be triggered by minor movements. This results in him having difficulty breathing and has interfered with his sleep. These symptoms often go away after a few days, but leave him with a sore abdomen.
In addition to abdominal pain, he reports some numbness in his left leg. He does not report any pain in the back, muscle twitching or weakness. Finally, he reports no family history of similar abdominal pain issues.