The patient is 69-year-old gentleman who presents to the ED complaining of rectal bleeding which has been present for about the past week. He claims past for large amount of bloody stool in the ED. His stool is guaiac is positive. There is no evidence of hemorrhoids. Work up in the ED reveals him as an abdominal CAT scan to have cholelithiasis but no acute cholecystitis. There is a cystic-appearing structure within the proximal pancreatic body and some colonic diverticular disease and he has a large right inguinal hernia with multiple nondilated loops of small bowel, nonobstructive. There is some mild elevation of his troponin therefore he was admitted acutely inpatient. Hemoglobin and hematocrit are stable and remained stable. I discussed
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
On later reflection I realized I could have though about interstitial cystitis, appendicitis and renal calculi. My multiple hypotheses for this patient are presented in Table 1.
Abdomen: The lipases appeared unremarkable. The liver, spleen, gallbladder adrenals, kidneys, pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seemed consistent with acute appendicitis. All the structures of the abdomen appeared unremarkable. No free air was seen.
History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and
History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and
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
B.S. is an 81 year old Caucasian female presenting with abdominal pain, diarrhea, nausea and vomiting in the emergency room on February 3, 2013. B.S. has a history of glaucoma, hypothyroidism, degenerative arthritis and diverticulosis. She has allergies to iodine and vicodin. B.S. is admitted for diverticulitis with possible partial bowel obstruction and hydronephrosis. B.S. was admitted on February 3, 2013 here at Verdugo Hills Hospital.
Experts claim that the consumption of the mixture within the morning, on an empty abdomen, prevents the expansion of gallstones. Moreover, the consumption of a glass of water, olive oil, and juice an hour before the breakfast will detoxify the liver, kidneys, and the
of abdominal pain and bleeding per rectum since 3 months. On examination he had diffuse
Different approaches are available to the surgeon for treatment of congenital cholesteatomas depending on the location and extent of the disease. Here we introduce a novel approach for a cholesteatoma seen through the anterior superior quadrant of the tympanic membrane. For three patients with such a cholesteatoma we removed their cholesteatomas after the amputation of the malleus handle using a semiconductor laser with or without reconstruction of the handle.
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.
Cholecystitis is a disease in which the gallbladder becomes inflamed. This disease is caused by an obstruction of bile flow. Which is due to having gallstone. Cholecystitis happens when bile flow is obstructed in the gallbladder. Then it becomes overly concentrated causing the irritation of the lining of the gallbladder.
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.
Cholecystitis is inflammation of the gallbladder. Inflammation usually forms when a gallstone blocks the cystic duct that transports bile. Cholecystitis is the most common problem resulting from gallbladder stones (90% of the cases).