Mr. G 33 year old male presenting to the ER with a history of acute sharp pain in his
right upper quadrant with vomiting. He reports no diarrhea but has mild constipation. His
vitals are stable and his abdomen has guarding on the right quadrant no rigidity. During
the course of the investigations, he reports to a nurse that his wife died 2 days ago and
his father 3 weeks ago . He is depressed . He is admitted to psychiatry after his
investigations are normal and his pain is Relieved with Toradol (Ketorolac). The psych-
residents detect a change in his story and investigate his Family. He does not give a
phone number and says everyone in his family is away. He is angry with a nurse who catches
him smoking and he discharges himself AMA.
The most likely diagnosis in his case is:
1) Conversion diagnosis
2) Somatoform diagnosis
3) Factitious disorder
4) Bereavement
5) Major depression