A41-year-old man no previous history of medical illness Chief complaint: intermittent upper abdominal pain and acid regurgitation for two months Symptoms: fever occurred when the abdominal pain frst started vital signs T369 C, P95 /min, R16/min, BP140/71 mmHg Physical examination: mild epigastric tenderness• A 41-year-old man • no previous history of medical illness • Chief complaint: intermittent upper abdominal pain and acid regurgitation for two months. • Symptoms: fever occurred when the abdominal pain frst started. • vital signs :T36.9 ℃, P95 /min, R16 /min, BP140/71 mmHg. • Physical examination: mild epigastric tenderness