Rruq Pain 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

He was able to tolerate PO earlier around 6am. but now denies having an appetite. Patient had very small bowel movement earlier this morning that was not normal for him. He has not passes has the morning. 'he is voiding well. Denies fevers, chills or night sweats. The pain is localized to the RLQ without radiation at this point. He has never had a colonoscopy.

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.

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

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

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

Complex regional pain syndrome (CPRS) formerly known as reflex sympathetic dystrophy is an autonomic and central nervous system disease that results in an individual’s experiencing chronic pain (Ferrillo, 2016). Pain usually happens in one or more generalized region of the extremities, such as the arms, hands, legs, or feet, but can also affect other parts of the body. Although the particular origin of the disease is undetermined, the majority of the time CRPS is caused by a significant trauma; such as a fracture, sprain, burn, cut, bruise, limb immobilization, or a surgical procedure (Ferrillo, 2016). CRPS stems from a neurological dysfunction that generates severe pain, mild or dramatic changes in skin color, temperature, and swelling in the affected area (National Institute of Neurological disorders and Stroke, 2015). There are two types of complex regional pain syndrome, type I is no apparent nerve injury and may it develop following a noxious event that may or may not have been traumatic. Types II develop after a nerve injury of the affected area (Carr, Cerda, & Fiala, 2016).

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

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.

In this study, out of 112 patients operated for acute non perforated appendicitis, 72 patients were male and 40 patients were female, a ratio of 1.8:1. The patients' age ranged from 18 to 55 years with a mean age of 26 years, the majority of cases lie in a range between 20-32 years. As shown in Table 1, there is no significant difference regarding patients' age, sex, medical comorbidities (diabetes, liver disease, renal disease, hyperlipidemia, heart disease), fever, leukocytosis, radiologic findings (appendiceal diameter, presence of free fluid) or operative time between the two groups.

Complex regional pain syndrome (CRPS) is characterised by pain in combination with sensory, autonomic, trophic and motor abnormalities. There are two forms of CRPS and they are referred to as CRPS type 1 and CRPS type 2. CRPS type 1 is also known as Reflex sympathetic dystrophy syndrome (RSD). And type 2 is known as Causalgia.1-2

The National Institute of Neurological Disorders and Stroke (NINDS) implies that acute pain, left untreated, can lead to chronic pain. Chronic pain affects more Americans than diabetes, heart disease and cancer combined and leads the cause of long-term disability in America.

If you are one of the millions who suffer from chronic pain, you know that finding the right pain management professionals can be a daunting experience. There are many theories as to the best way to treat chronic pain. You want to find an experienced and successful center for pain management in order to achieve the best results in managing your pain.