March 10, 2017 Sharon Strobe, MD Toronto University Medical Centre 250 University Avenue Toronto, ON M2P 484 Dear Dr. Strobe Re: patient James Welton, DOB August 17, 1984 The patient is a 32-year-old male who had eaten dinner and later complained of pain in his right side from the lower ribs to the hip and radiating around to the back. The pain gradually worsened, and he became nauseated and vomited many times in the evening, When the pain became severe, he was taken to the ER at Sunnybrook Hospital. On physical examination, the patient was found to be in acute distress and suffering ftom mild dehydration. His right abdomen was acutely tender on palpation. There were no palpable masses. Rectal examination was WNL. He was treated with Demoral 76 mg intramuscularly, and he was admitted to the hospital for observation and further evaluation, During his hospitalization, an abdominal ultrasound revealed cholelithiasis, and a laparoscopic cholecystectomy was performed. He had an uneventful hospital course and was discharged 3 days postop. He will return to my office in 2 weeks for follow up. _ ‘Thank you for referring this patient to me. Sincerely / Anwar Hossain, MD Gastroenterology Clinie AH:me Margaret Clement OAME-260(003) Ha WINTER 2017\0AME 260 (003)\Tests\Welton, J-LET-Margaret Clement,docx