Gastrointestinal Diagnosis Cases

Gastrointestinal diagnosis cases on Saturn Dx train you to reason through abdominal pain, vomiting, bleeding, jaundice and changes in bowel habit. This free gastroenterology diagnosis game gives you 125 clinical cases, each revealed one clue at a time.

How our gastrointestinal diagnosis cases work

Pick a difficulty (Easy, Medium or Hard) and start a case. You see the patient presentation first. Type your diagnosis, and if it is wrong the next hint unlocks: examination findings, then laboratory results, then imaging or other investigations. The fewer hints you need, the more points you earn, and at the end you read a short explanation of why the diagnosis fits.

Why practise gastrointestinal diagnosis cases?

The digestive tract and the liver produce a wide range of symptoms, and the location, timing and character of abdominal pain are often the most useful clues. A patient with upper abdominal pain might have an ulcer, gallstones or pancreatitis, while bleeding or weight loss raises a different set of questions. Practising these cases builds the habit of mapping symptoms to anatomy before choosing tests.

What you learn from each case

Every one of these gastrointestinal diagnosis cases ends with the same three things: the correct diagnosis, a short explanation of the reasoning, and the full list of clues so you can see where your thinking went right or wrong. Over time you start to recognise typical patterns in gastrointestinal medicine, you remember the key investigations for each condition, and you become faster at ruling out the dangerous causes first. Use the difficulty setting to begin with classic presentations and then move on to harder, more subtle cases.

Topics in the gastrointestinal diagnosis game

This area of medicine covers presentations such as:

• peptic ulcer disease and gastrointestinal bleeding
• inflammatory bowel disease
• celiac disease
• acute pancreatitis
• liver disease and cirrhosis
• gallstone disease and cholangitis
• appendicitis and bowel obstruction
• esophageal, gastric and colorectal cancer

How to approach a gastrointestinal case

Start with the pain: where it began, where it moved, what makes it better or worse, and whether it comes with vomiting, fever or jaundice. Note red flags such as bleeding, weight loss and anemia. When laboratory results or imaging appear, ask whether they point to the liver, the bile ducts, the pancreas or the bowel.

• Write down two or three possible diagnoses before you type an answer.
• Use every hint to rule something in or out, not only to confirm your first idea.
• Read the explanation after each case, even when you were right.

Trusted resources to read next

After a case, deepen your understanding with American College of Gastroenterology for guidance and patient resources on digestive health, and NIDDK digestive diseases for clear explanations of digestive conditions.

Keep studying with Saturn Medic

Test yourself with the Saturn Medic Question Bank, revise key facts with our medical flashcards, or return to the medical diagnosis game home page. You can also practise another system:

• Cardiovascular diagnosis cases
• Respiratory diagnosis cases
• Endocrinology diagnosis cases
• Renal System diagnosis cases
• Hematology diagnosis cases
• Infectious System diagnosis cases

Gastrointestinal diagnosis game FAQ

Are these gastrointestinal diagnosis cases free?

Yes. Every gastrointestinal case on Saturn Dx is free to play, and there is no limit on how many you can try. There are currently 125 gastrointestinal cases.

How many hints do I get in a gastrointestinal case?

Each case has between four and six clues. You start with the history, and every wrong answer unlocks the next hint, such as examination findings, laboratory results or imaging.

Are the gastrointestinal cases real patients?

No. They are original teaching scenarios written to match standard textbook presentations. Our team reviews each case before it goes live, and no real patient records are used.

All 125 gastrointestinal cases

1. Gastrointestinal case #107 - A 34-year-old woman has felt tired and bloated for 8 months.
2. Gastrointestinal case #108 - A 24-year-old man has had bloody diarrhoea for 3 weeks.
3. Gastrointestinal case #109 - A 47-year-old man has had severe upper abdominal pain for 6 hours.
4. Gastrointestinal case #141 - A 48-year-old man has had burning upper abdominal pain on and off for 6 weeks.
5. Gastrointestinal case #142 - A 38-year-old woman has had upper abdominal and chest discomfort on and off for several months.
6. Gastrointestinal case #143 - A 22-year-old student has felt unwell for 5 days with headache, aching muscles and joints, nausea and loss of appetite.
7. Gastrointestinal case #144 - A 58-year-old man has had increasing tiredness, poor appetite and weight loss for 6 months.
8. Gastrointestinal case #145 - A 32-year-old woman has had difficulty swallowing for 8 months.
9. Gastrointestinal case #146 - A 52-year-old woman has had tiredness and generalised itching for a year.
10. Gastrointestinal case #147 - A 46-year-old man of northern European descent has had tiredness and aching hands for a year.
11. Gastrointestinal case #148 - A 24-year-old woman with a previous autoimmune disease has had 4 months of tiredness, poor appetite and aching joints.
12. Gastrointestinal case #149 - A 33-year-old man has had tiredness and itching for 6 months, with two brief episodes of jaundice.
13. Gastrointestinal case #150 - A 17-year-old boy has had 3 months of a tremor in his hands and clumsy handwriting.
14. Gastrointestinal case #215 - A 24-year-old man has had colicky right-sided abdominal pain, tiredness and weight loss for 6 months.
15. Gastrointestinal case #216 - A 29-year-old woman has had crampy lower abdominal pain for 2 years. It eases after she opens her bowels and flares at times of stress.
16. Gastrointestinal case #217 - A 68-year-old man has had a change in his bowel habit for 3 months, with pellety stools and a feeling that he has not emptied his bowel.
17. Gastrointestinal case #218 - A 52-year-old woman has had constant severe right upper abdominal pain for 12 hours. It began after a fatty meal and she has had similar…
18. Gastrointestinal case #219 - A 45-year-old man has become yellow over 10 days after a prolonged drinking binge. He has drunk heavily for many years.
19. Gastrointestinal case #220 - A 47-year-old man with a 20-year history of heavy alcohol use has had repeated attacks of epigastric pain for 5 years.
20. Gastrointestinal case #221 - A 62-year-old man has known chronic liver disease from long-standing hepatitis B infection and attends a 6-monthly liver clinic.
21. Gastrointestinal case #222 - A 62-year-old woman has had watery, non-bloody diarrhoea 6 to 8 times a day for 4 months, including at night. She has not lost much weight.
22. Gastrointestinal case #223 - A 58-year-old overweight man who smokes has had heartburn and acid regurgitation for over 15 years.
23. Gastrointestinal case #224 - A 25-year-old man has had difficulty swallowing solid food for 2 years. Last month a piece of steak stuck and he needed endoscopic removal.
24. Gastrointestinal case #225 - A 19-year-old man has noticed fresh blood and mucus in his stools for several months. His father had a bowel operation at the age of 38.
25. Gastrointestinal case #226 - A 41-year-old woman is found to have a cancer of the right colon. She feels tired and has had mild abdominal pain.
26. Gastrointestinal case #324 - A 66-year-old man has had difficulty swallowing for 3 months. At first he could not swallow bread or meat, and now he struggles with soft…
27. Gastrointestinal case #325 - A 63-year-old man from a high-incidence region has had 4 months of epigastric discomfort, early satiety and nausea. He has lost 8 kg.
28. Gastrointestinal case #326 - A 68-year-old woman with long-standing constipation has had 3 days of constant left iliac fossa pain and fever. She takes ibuprofen for her…
29. Gastrointestinal case #327 - A 69-year-old man has had 2 months of a gnawing upper abdominal pain that goes through to his back and eases when he leans forward. He has…
30. Gastrointestinal case #328 - A 57-year-old man with known alcohol-related liver disease vomited a large amount of fresh red blood at home and then felt faint.
31. Gastrointestinal case #329 - A 61-year-old man with cirrhosis is brought in by his wife because he has been sleeping all day and awake at night, and today he does not…
32. Gastrointestinal case #330 - A 26-year-old man has had 10 days of tiredness, nausea, joint pains and loss of taste for cigarettes, followed by dark urine and yellow…
33. Gastrointestinal case #331 - A 48-year-old man has had mild tiredness and a dull right upper abdominal discomfort for a year. He drinks 2 units of alcohol a week.
34. Gastrointestinal case #332 - A 60-year-old woman with known gallstones has had two days of right upper abdominal pain, shaking chills and yellow eyes.
35. Gastrointestinal case #333 - An 82-year-old woman in a care home who is mostly bed-bound has had two weeks of passing small amounts of watery brown stool and lower…
36. Gastrointestinal case #334 - A 52-year-old man had a partial gastrectomy for a bleeding ulcer 6 months ago. Within 20 minutes of a large sweet meal he feels dizzy…
37. Gastrointestinal case #335 - A 64-year-old woman with systemic sclerosis has had bloating, loose pale stools and weight loss for 8 months. She has also become tired.
38. Gastrointestinal case #336 - A 9-year-old boy has had constipation since birth. He needs enemas to open his bowels and his abdomen is often swollen. He passed meconium…
39. Gastrointestinal case #337 - A 59-year-old man with known cirrhosis and ascites has had two days of fever, vague abdominal pain and increasing confusion. He has had no…
40. Gastrointestinal case #338 - A 55-year-old man with alcohol-related cirrhosis and ascites was admitted with a urinary tract infection. Over 4 days his urine output has…
41. Gastrointestinal case #339 - A 47-year-old man is found to have abnormal liver tests at an insurance medical. He injected drugs briefly in his twenties and feels well.
42. Gastrointestinal case #340 - A 24-year-old man returned from a village in northern India 3 weeks ago after a flood. He has had fever, nausea and dark urine for a week.
43. Gastrointestinal case #341 - A 45-year-old man was admitted with severe alcohol-related acute pancreatitis 6 weeks ago. He now has persistent upper abdominal pain…
44. Gastrointestinal case #342 - A 74-year-old man with chronic heart failure was admitted after a cardiac arrest and prolonged hypotension that was corrected after 20…
45. Gastrointestinal case #343 - A 32-year-old woman has had 3 weeks of abdominal swelling and right upper abdominal pain. She has a known blood disorder and takes no…
46. Gastrointestinal case #344 - A 41-year-old man has had burning epigastric pain for 3 years and watery diarrhoea for 1 year. Ulcers recurred after a full course of…
47. Gastrointestinal case #345 - A 52-year-old man from Europe has had 2 years of migrating joint pains, followed by weight loss, loose pale stools and low-grade fever…
48. Gastrointestinal case #346 - A 38-year-old man known to carry the surface antigen of hepatitis B for years, who has been well, becomes acutely jaundiced after sharing…
49. Gastrointestinal case #347 - A 78-year-old woman with a long history of gallstone attacks has had 4 days of colicky central abdominal pain, repeated vomiting and no…
50. Gastrointestinal case #348 - A 24-year-old woman has had 8 months of refractory watery diarrhoea, weakness and cramps. She has had normal stool cultures and a normal…
51. Gastrointestinal case #535 - A 34-year-old man has had 3 weeks of pain on swallowing and a sensation of food sticking behind the sternum. He lost 5 kg over 4 months.
52. Gastrointestinal case #536 - A 74-year-old woman has had 18 months of difficulty swallowing meat and bread, but liquids go down easily. She has had no heartburn for…
53. Gastrointestinal case #537 - A 68-year-old woman has been tired and breathless on exertion for 3 months. She sometimes has mild heartburn after large meals.
54. Gastrointestinal case #538 - A 63-year-old woman developed severe retrosternal pain and pain on swallowing the morning after taking a new weekly tablet for…
55. Gastrointestinal case #539 - A 72-year-old man has a 2-year history of difficulty starting to swallow, with food sticking in the throat. He sometimes regurgitates…
56. Gastrointestinal case #540 - A 52-year-old man drank heavily at a party, then vomited violently several times. He then developed severe chest pain that was constant and…
57. Gastrointestinal case #541 - A 45-year-old man with chronic back pain took large amounts of ibuprofen for a week. He has had upper abdominal discomfort, nausea and one…
58. Gastrointestinal case #542 - A 52-year-old woman with autoimmune thyroid disease has had 6 months of increasing tiredness, tingling in the feet and a sore tongue. She…
59. Gastrointestinal case #543 - A 46-year-old woman with type 1 diabetes for 25 years has had months of early fullness after eating, recurrent vomiting of food eaten many…
60. Gastrointestinal case #544 - A 58-year-old man who takes naproxen for arthritis suddenly developed severe upper abdominal pain that spread across the whole abdomen. The…
61. Gastrointestinal case #545 - A 38-year-old woman notices bright red blood on the toilet paper and in the pan after opening her bowels. She has been constipated and…
62. Gastrointestinal case #546 - A 29-year-old woman has severe tearing pain on opening her bowels lasting an hour afterwards. She sees small streaks of bright red blood on…
63. Gastrointestinal case #547 - A 41-year-old man has had 4 days of increasing throbbing pain beside his anus. It hurts to sit, and he has felt feverish.
64. Gastrointestinal case #548 - A 24-year-old student of Asian descent has had cramping abdominal pain, bloating and loose stools starting within an hour of drinking milk…
65. Gastrointestinal case #549 - A 76-year-old woman with heart failure and atrial fibrillation had sudden cramping pain in the left lower abdomen, followed by passing…
66. Gastrointestinal case #550 - A 80-year-old man with atrial fibrillation not on anticoagulation has had 6 hours of severe, constant central abdominal pain that came on…
67. Gastrointestinal case #551 - A 45-year-old overweight woman has had several night-time attacks of upper abdominal pain lasting a few hours, usually after a heavy meal…
68. Gastrointestinal case #552 - A 61-year-old woman had a gallbladder removed 10 years ago. She now has episodes of right upper abdominal pain with dark urine and pale…
69. Gastrointestinal case #553 - A 21-year-old man notices mild yellowing of the eyes during exams, after a viral illness and when he skips meals. He is otherwise well…
70. Gastrointestinal case #554 - A 58-year-old man has episodic severe central chest pain at rest, sometimes triggered by hot drinks, lasting about 15 minutes. Occasionally…
71. Gastrointestinal case #555 - A 44-year-old woman with colour changes in her fingers in the cold has had 2 years of heartburn and difficulty swallowing both solids and…
72. Gastrointestinal case #556 - A 36-year-old man has had 5 months of vague upper abdominal discomfort and bloating after meals. He has no weight loss, vomiting or…
73. Gastrointestinal case #557 - A 67-year-old man has had 2 weeks of fever, sweats and right upper abdominal discomfort. He was treated for diverticulitis last month.
74. Gastrointestinal case #558 - A 31-year-old woman who has taken the combined oral contraceptive for 10 years has had 3 days of sudden severe right upper abdominal pain…
75. Gastrointestinal case #559 - A 38-year-old woman has a liver ultrasound for mild abdominal bloating. She takes the oral contraceptive pill and is otherwise well with no…
76. Gastrointestinal case #560 - A 44-year-old woman has an abdominal ultrasound for suspected gallstones. She has no abdominal pain, weight loss, jaundice or history of…
77. Gastrointestinal case #561 - A 24-year-old man with 3 weeks of bloody diarrhoea (up to 14 stools a day) has become increasingly unwell with abdominal pain and…
78. Gastrointestinal case #562 - A 78-year-old woman is recovering on the ward after hip fracture surgery. On day 4 her abdomen swells massively over a day, with little…
79. Gastrointestinal case #563 - A 66-year-old man, a heavy smoker, has had 8 months of dull severe central abdominal pain starting about 30 minutes after meals. He has…
80. Gastrointestinal case #564 - A 27-year-old man has had months of passing small amounts of blood and mucus per rectum with a sense of incomplete emptying. He often…
81. Gastrointestinal case #565 - A 28-year-old woman has had 18 months of bloating, early satiety and nausea after meals, but no weight loss, vomiting, bleeding or…
82. Gastrointestinal case #566 - A 61-year-old woman has had 5 months of epigastric discomfort with early satiety and mild anaemia-related tiredness. She has no weight loss…
83. Gastrointestinal case #567 - A 14-year-old boy has had two episodes of painless passage of dark red blood per rectum over six months. He feels dizzy and tired.
84. Gastrointestinal case #568 - A 19-year-old woman has had recurrent crampy abdominal pain and iron-deficiency anaemia. Her father had intestinal operations at a young…
85. Gastrointestinal case #569 - A 33-year-old woman had 40 cm of terminal ileum removed for a stricture 2 years ago. She now has urgent watery diarrhoea 6-8 times daily…
86. Gastrointestinal case #570 - A 36-year-old man has had two episodes of vomiting blood over six months. He has no history of liver disease or alcohol excess; as a baby…
87. Gastrointestinal case #571 - A 57-year-old man with alcohol-related cirrhosis has become progressively breathless over a year. He notices that breathlessness worsens…
88. Gastrointestinal case #572 - A 38-year-old woman with a long-standing cough and breathlessness, who has never smoked, has persistently raised transaminases. She does…
89. Gastrointestinal case #573 - A 33-year-old man has intensely itchy crops of small blisters on his elbows, knees and buttocks for 2 years, with scratch marks and little…
90. Gastrointestinal case #574 - A 42-year-old man who has lived in southern India for 2 years has had 3 months of watery diarrhoea, bloating, tiredness and weight loss. It…
91. Gastrointestinal case #575 - A 55-year-old man has had 6 months of leg swelling and tiredness. He has mild upper abdominal discomfort and no diarrhoea.
92. Gastrointestinal case #576 - A 33-year-old woman has had a few months of early satiety and vague epigastric discomfort. Her mother died of stomach cancer at age 42 and…
93. Gastrointestinal case #577 - A 74-year-old woman with a long history of gallstones has had two months of persistent right upper abdominal pain, itching and weight loss…
94. Gastrointestinal case #578 - A 45-year-old man from South-East Asia has had four episodes in two years of right upper abdominal pain, fever with rigors and jaundice…
95. Gastrointestinal case #579 - A 29-year-old woman with asthma and eczema has had 6 months of colicky abdominal pain, nausea, vomiting, diarrhoea and weight loss. She has…
96. Gastrointestinal case #580 - A 19-year-old man has had swelling of both legs since childhood and recurrent bouts of loose pale stools. He has had two episodes of…
97. Gastrointestinal case #581 - A 63-year-old man has had 6 weeks of painless jaundice, itching and a 5 kg weight loss. He also has dry eyes and a swollen submandibular…
98. Gastrointestinal case #582 - A 58-year-old woman diagnosed with coeliac disease 8 years ago strictly follows a gluten-free diet. She now has 3 months of recurrent…
99. Gastrointestinal case #583 - A 62-year-old woman had pelvic radiotherapy with chemotherapy for cervical cancer 14 months ago. She now has crampy lower abdominal pain…
100. Gastrointestinal case #584 - A 24-year-old woman is brought in after taking an unknown number of paracetamol tablets 3 days ago, after an argument. She has had vomiting…
101. Gastrointestinal case #830 - A 76-year-old woman has had three episodes of passing a large amount of dark red blood from the back passage over the last year, each…
102. Gastrointestinal case #831 - A 72-year-old man on long-term aspirin for his heart suddenly passes a large amount of fresh maroon blood and clots per rectum. He has no…
103. Gastrointestinal case #832 - A 31-year-old woman in her 34th week of a first pregnancy has intense itching, worse at night. She has no rash, abdominal pain or fever.
104. Gastrointestinal case #833 - A 38-year-old overweight woman has severe constant upper abdominal pain that began suddenly after a fatty meal and has lasted three hours…
105. Gastrointestinal case #834 - An 80-year-old woman with long-standing heartburn develops sudden severe lower chest and upper abdominal pain, with repeated unproductive…
106. Gastrointestinal case #835 - A 24-year-old woman has had opening of the bowels only once a week since adolescence. She strains, feels bloated and often has a sense of…
107. Gastrointestinal case #836 - A 62-year-old man has had no bowel symptoms but was invited for a bowel-cancer screening test. His faecal occult blood test is positive.
108. Gastrointestinal case #837 - A 29-year-old man with long-standing Crohn disease reports pain and a persistent discharge from a small opening beside the anus. He has had…
109. Gastrointestinal case #838 - A 42-year-old man born in South-East Asia attends for insurance screening and is found to have abnormal liver tests. He has no symptoms and…
110. Gastrointestinal case #839 - A 35-year-old woman had a total proctocolectomy with an ileal pouch–anal anastomosis for ulcerative colitis two years ago. She now has 10…
111. Gastrointestinal case #840 - A 64-year-old woman with known gallstones has had two weeks of right upper abdominal pain, dark urine and yellow eyes. She has had no…
112. Gastrointestinal case #841 - A 58-year-old man is in the intensive care unit on day 12 after emergency bowel surgery. He is on parenteral nutrition and develops fever…
113. Gastrointestinal case #842 - A 22-year-old man has had three episodes of fever, rigors and right upper abdominal pain over a year. Each has settled with antibiotics…
114. Gastrointestinal case #843 - A 6-year-old girl has had intermittent abdominal pain and episodes of yellow eyes and pale stools over a few months.
115. Gastrointestinal case #844 - A 17-year-old boy has had three episodes in two years of intense itching, nausea and yellow discolouration of the eyes, each lasting about…
116. Gastrointestinal case #845 - A 45-year-old man is 12 days after a bone marrow transplant for leukaemia, preceded by high-dose chemotherapy and total body irradiation…
117. Gastrointestinal case #846 - A 38-year-old woman with a long history of systemic sclerosis has recurrent episodes of vomiting, abdominal distension and cramping pain…
118. Gastrointestinal case #847 - A 74-year-old man has had six months of passing large amounts of watery mucus per rectum. He has become weak and has had cramps and…
119. Gastrointestinal case #848 - A 26-year-old woman has had two days of severe colicky abdominal pain, vomiting and constipation, and has become anxious and confused. The…
120. Gastrointestinal case #849 - A 19-year-old man presents with vomiting a large amount of blood. He has had painful enlargement of the left upper abdomen since childhood.
121. Gastrointestinal case #850 - A 27-year-old woman in her first pregnancy, at 36 weeks with twins, has a week of nausea, vomiting and upper abdominal pain, and now feels…
122. Gastrointestinal case #851 - A 66-year-old woman with rheumatoid arthritis, treated with azathioprine for years, is found to have a low platelet count and a palpable…
123. Gastrointestinal case #852 - A 21-year-old man of Mediterranean origin has had a year of chronic diarrhoea, weight loss, anorexia and intermittent fever.
124. Gastrointestinal case #853 - A 19-year-old woman with chronic lung problems and pancreatic insufficiency is found to have abnormal liver tests at a routine review. She…
125. Gastrointestinal case #854 - A 44-year-old man has had intermittent rectal bleeding and iron deficiency anaemia. Neither of his parents had bowel cancer, but a sibling…

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