The possible causes of abdominal pain are multiple. It is important to differentiate because some causes can quickly become life threatening. Yet not only are there many, many causes of abdominal pain in the abdomen; in addition, there are abdominal problems that cause referred pain elsewhere in the body (commonly colic; and blood or infection irritating the diaphragm commonly causes shoulder pain), and there are problems elsewhere in the body that cause pain in the abdomen. While a 20-year-old man is more likely to have an acute condition (such as infection) causing abdominal pain and a 50-year-old man is more likely to have a chronic condition (such as IBD) causing his abdominal pain, we cannot have a hard and fast rule because of age. …show more content…
Also ask if it was sudden, rate the severity, ask if it radiates to other parts of the body, any other symptoms (such as vomiting). As far as history, ask about events leading up to the pain, if abdominal pain has occurred before and under what circumstances, what if anything has been tried to relieve the pain and if it wroked. One common possibility to keep prominently in mind for a 50-year-old man is that a myocardial infarction can present as abdominal …show more content…
Peritonitis (inflammation of the peritoneum) can result from many causes, but itself causes the influx of fluid into the peritoneum, resulting in severe dehydration and electrolyte imbalances, leading to respiratory distress, kidney failure, liver failure, disseminated intravascular coagulation, and death within days of onset. Laboratory and imaging tests are often not helpful, so can be done last, to make the final differential diagnosis from the limited set of possibilities we are able to determine after a complete history and physical. Normal lab results can occur even with significant disease, and abnormal lab results can occur even with mild disease and may not be specific enough to be diagnostic. An exception would be serum lipase, which would indicate acute pancreatitis. CT scans are usually the most useful when there is significant abdominal pain, but in emergency cases, the patient should probably proceed to surgery rather than wait for imaging results. The high number of diagnoses to be ruled out in a patient presenting with abdominal pain make them impossible to cover in a short paper. The reader is encouraged to refer to the figure in the reference below regarding differential diagnoses based on the location of the pain, a copy of which could be printed out and kept on hand as a diagnostic aid in the clinical
HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around
INTRODUCTIONThis is a case study concerning a patient presenting with low abdominal pain, frequent micturation and dysuria. I will discuss the consultation and show how I used the problem solving consultation style detailed by Alison Crumbie. This involves listening to the patients' initial complaint and developing hypothetical diagnosis. Focused questioning and clinical examination and investigations will then be used to eliminate some of the initial hypotheses. The patients' perspective of their problem will be addressed and the synthesis of gathered information will enable the practitioner to arrive at a differential diagnosis and to agree on a treatment plan with the patient so that they can manage their problem.
HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now
Sakeenah is 14 years old African american girl, she comes to the University of Michigan Pediatric Gastroenterology clinic on 5/22/2018 complaining of abdominal pain. She is accompanied mom and dad today and she provides the interval medical history, She states that the pain started month ago, epigastric, and occasionally radiate to right side, described as squeezing or burning pain. She states that the pain is on/off, in scale of 7-8/10, occur more in the morning. The pain lasts few hours several time a day. She feels that "food sits in my stomach and doesn't digest." Sakeenah states that pain is worse when she eating a grassy food, she stop eating it for a while and the pain seems
T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips
The patient states she feels as though her abdominal pain after full workup by the gastroenterologist, is likely related to muscular symptoms. She does state there are certain ways she can move, that she will get the pain.
* Refer to primary care doctor to address ongoing pain in stomach client reported it uncontrolled for several month with over the counter medications and to rule out any other medical problems or symptoms.
DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were
Order abdominal X-rays. A test that uses sound waves to take pictures of the inside of the body (ultrasound) may also be done.
It is always challenging to accurately diagnose abdominal pain in the primary care settings. An extensive knowledge of the anatomy and physiology could help narrow down possible causes of abdominal pain.
Patient might experience mild or sever pain, crampy, and aching that is similar to appendicitis. Passing of gas or stool elimination may reduce the adverse effect of pain. According to spivak & deSouza (2008), patient that are of high risk are those with the history of low-fiber diet, constipation, high intake of red meat, severe dehydration, and aging. The diagnostic tests are barium enema which determines number of diverticula, CBC indicates present of anemia, colonoscopy exposes present of diverticula, CT scan reveals changes in the colon wall, GI bleeding scan that identifies active bleeding, and CBC with differential reveals leukocytosis.
I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.
ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.
My patient is a 64-year-old that came in for upper abdominal pain. She felt her pain was worse when she lied down flat, so she had been trying to sit up and lean forward for most of the day. As the day went on her pain got worse, so she came into Emergency Department for further evaluation. She did not have any nausea or emesis and no change in her bowel habits. No fevers or chills. No trauma to the abdomen. In the hospital, she is diagnosed with acute pancreatitis.
The common cause of acute abdomen is acute appendicitis and the reason for abdominal surgeries. Its diagnosis is still a big challenge because of many other condition similar to the acute appendicitis like renal colic, colitis, adenitis etc. Primary imaging modality for the acute abdominal pain in pediatric age group is a plain x-rays of the abdomen, followed by ultrasound. Further imaging depends on the results of these studies (17) . The normal appendix could be visualized with graded-compression sonography, and need to be differentiate between normal and abnormal appendix (21,23,24,25).