LLQ pain & Vomiting
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History of Present Illness:
A man in his 60s with a history of COPD presents to the ED for 5 days of non-radiating intermittent lower abdominal pain that is a bit worse on the left and 2 days of intermittent vomiting. Both got worse today. He doesn’t recall when his last BM was but states he usually goes every 2-3 days. He denies any fever, bleeding or other complaints
Vital Signs & Physical Exam:
Vital signs are normal except for moderately elevated BP. The abdomen is tender in BLQ without guarding
Initial Differential Diagnosis:
- diverticulitis
- SBO
- Kidney stone
Initial Diagnostic Testing:
- Labs: none ordered
- Imaging: see below
QUESTIONS:
- What does the case image show?
- What should you do next?
- Want a 1-minute consult/tutorial on this case?
- Want to know what happened with this patient?
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ANSWERS:
- What does the case image show? The image shows an 8 cm leaking AAA.
- What should you do next? Type and cross, consult IR and vascular surgery
- Want a 1-minute consult/tutorial on this case? See yellow area from sample page below.
- Want to know what happened with this patient? See case conclusion below tutorial page.
1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook
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CASE CONCLUSION: Went to IR for repair. Did well.