Moaning & Vomiting
UnFiNiShEd CaSe CoMe BaCk LaTeR
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History of Present Illness:
A 62-year-old female presents to the ED in the early afternoon for 3 days of abdominal bloating and occasional vomiting but then severe generalized abdominal pain starting 2 hours ago. She had a BM this morning that was normal. She denies any fever, diarrhea, bleeding or other complaints.
Vital Signs & Physical Exam:
Vital signs are normal except for BP in the 180s systolic. Physical exam is otherwise normal except for diffused guarding without rebound and a patient who is moaning in pain.
Initial Differential Diagnosis: SBO, AAA, ACS
Initial Diagnostic Testing:
- Labs: none ordered
- Imaging: KUB is normal, US: see below
QUESTIONS:
- What does the case image show?
- What should you do next?
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- Want to know what happened with this patient?
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ANSWERS:
- What does the case image show? The image shows dilated fluid filled loops of bowel
- What should you do next? Order a CT. Treat for SBO. Consult 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.
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CASE CONCLUSION: Went to the OR
CASE LESSONS: