Epiploic Appendagitis Case Studies

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

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.

He admits to a 25 pound weight gain over the last few months. The patient was

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.

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.

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) Place hand above right knee and ask pt to raise the leg to meet your hand. Pain may indicate appendicitis.

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

This patient presented to the emergency department (ED) with pain in his upper right quadrant and flank. He reported experiencing abdominal distention

Mr. Johnson’s reason for driving himself to the emergency room and the symptoms he is experiencing in conjunction with test, and lab results led me to this conclusion. Johnson noticed pain from his epigastric region, radiating to the right shoulder and scapular region. During his emergency room physical exam the physician noted, palpation of the epigastric region demonstrated tenderness with guarding, an above normal body temperature, increased blood pressure, as well as an increased heart rate. The increase in body temperature can be linked to a gallbladder infection. The pain Mr. Johnson is feeling radiating to the

The ultrasound will look for the presence of gallstones, inflammation of the liver, blockage of the bile duct, thickened gallbladder walls or an oversized bile duct tract. An ultrasound can detect gallstones that are two millimeters or larger in size.

Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

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.

A 54-year-old man presents acutely with anterior NSTEMI and is treated with PCI (Drug eluting stent) to the LAD and placed on DAPT (aspirin 300mg and ticagrelor 75 mg bd). He subsequently develops abdominal pain, which is confirmed as acute appendicitis on CT scan and is referred by the surgical unit for laparoscopic appendicectomy.

Testicular torsion is most commonly seen in early puberty and results when the arteries and veins in the spermatic cord twist, reducing or stopping circulation to the testis. Vascular engorgement and ischemia develop, causing scrotal swelling and pain. The patients experience an acute pain that localizes in the affected testicle, however, the pain may also radiate to the inguinal areas or abdomen. Abdominal discomfort, nausea, and vomiting accompany the pain (Goolsby, & Grubbs, 2015). Diagnostic testing includes urinalysis to rule out infection and color Doppler ultrasonography. Torsion of the testis is an emergency and the treatment may require performing a surgery if the torsion cannot be reduced manually. The surgery must be performed within 6 hours after the onset of