A COMMON PRESENTATION IN AN UNCOMMON DISEASE; RIGHT UPPER QUADRANT PAIN • INTRODUCTION The presentation of abdominal pain is a common one, it is very non-specific and can be challenging to diagnose. When abdominal pain is localized to the right upper quadrant (RUQ), a broad range of differentials come to mind in relation to the underlying organs in that region. These differentials are narrowed down based on other parts of the history like the onset and duration of the pain, age, sex, associated symptoms like fever, nausea, vomiting etc, and comorbid conditions. Right upper quadrant pain can be benign but it can also signal serious pathology. Early diagnosis is key to preventing serious complications. This case presentation aims to highlight a presentation of right upper quadrant abdominal pain in a 36-year-old male which heralded a more sinister pathology despite the absence of risk factors. • CASE REPORT A 35 year old African-American male with a past medical history of hepatic hemangioma and borderline hypertension presented with a one-week of intermittent fevers and progressively worsening sharp right upper quadrant abdominal pain. Associated symptoms are chills, night sweats and fatigue. He denied any recent sick contacts, recent travel or changes in his water source. He denied weight loss, cough, nausea, vomiting, chest pain, shortness of breath, dysuria, hematuria, headache, changes in stool, blurry vision, and no joint pain. Patient endorsed decreased in appetite,
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.
The patient had a sudden onset of lower left quadrant pain and was diagnosed with
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
Patients present with left lower quadrant pain, reiterating the tendency for diverticulitis to affect the sigmoid colon in western countries. The pain can be constant or intermittent, and lack of appetite, or nausea and vomiting can be present. Physical examination of the abdomen reveals localized tenderness but frank rebound or guarding should be negative. Bowel sounds are frequently distant or depressed, if bowel sounds are very active an obstruction may be present, in mild cases the bowel sounds may be normal. The WBC may be elevated and the patient may present with a fever. Occasionally a palpable mass may be felt and may be very painful. Eating exacerbated the pain of left-sided diverticulitis and pain can be lessened with the passage of feces or flatus. Patients may complain of a feeling of being bloated.
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
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.
Melissa Johnson is a 45-year-old woman who today was seen on an emergency basis when she called the office complaining of left upper quadrant pain. The patient stated that the pain has been increasing for about three months. The patient’s most notable symptom is increased belching. The patient also experiences heart burn, increased satiety, and intermittent left upper quadrant pain. The patient denies any vomiting, change in bowel habits, melena, or dysphagia. She also denies having chills, fever or rigors. The patient states that she has not been examining her sugars, and she has not felt any chest pain with exertion or dyspnea. In addition, the patient denies any orthopnea, pedal edema, or paroxysmal nocturnal
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
One symptom that is not definite, but may help decide what form of IBD is present, is where the pain in the abdomen is located. Typically Ulcerative Colitis patients experience pain in the lower left section of the abdomen, while Crohn’s Disease patients tend to suffer from pain in the lower right section of the abdomen. “With Ulcerative Colitis, bleeding from the rectum during bowel movements is very common, and bleeding is much less common in patients with Crohn’s Disease.” (Tresca, 2009)