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75yr old male came with pain over abdomen since 15 days

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18/6/33 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment. CHIEF COMPLAINTS A 75 year old male, farmer came to OPD with chief complaints of swelling over the abdomen since 5 years and pain over the swelling since 15 days. HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 5 years ago and then he noticed a swelling over his epigastric region, insidious in onset, size of a peanut which gradually progressed to the present size like lemon . It was slightly reducible to lying down. No aggravating and relieving factors. Pati...