Abdominal Presentation Scenario

You’re called to a 72-year-old male with reports of abdominal pain. He hasn’t felt right in a while with worsening shortness of breath, lethargy, and intermittent mild abdominal pain. He has an appointment booked with the GP however today the abdominal pain is more severe, so he called 999. On arrival the patient is alert yet looks slightly pale. He states he has had intermittent upper abdominal pain all day that has been increasing to 8/10 at points. He has taken his paracetamol and ibuprofen to help.