,HOSPITAL COURSE: , This is a 78-year-old female with past medical condition includes hypertension, end-stage renal disease, hyperlipidemia, hypothyroidism, and skin lymphoma who had a left AV fistula done about 3 days ago by Dr. X and the patient went later on home, but started having epigastric pain and right upper quadrant pain and mid abdominal pain, some nauseated feeling, and then she could not handle the pain, so came to the emergency room, brought by the family. 
,HOSPITAL COURSE : , This is a 78 - year - old female with past medical condition includes hypertension , end - stage renal disease , hyperlipidemia , hypothyroidism , and skin lymphoma who had a left AV fistula done about 3 days ago by Dr. X and the patient went later on home , but started having epigastric pain and right upper quadrant pain and mid abdominal pain , some nauseated feeling , and then she could not handle the pain , so came to the emergency room , brought by the family .