Triage: Pt awoke with severe mid abdominal pain today. Loose stool, denies N/V or urinary symptoms. Hx: of intestinal rupture pt reports pain similar. In obvious discomfort.
History of Present Illness: A man in his mid 40s presents with 1 day of mid abdominal pain that feels similar to when he had perforated diverticulitis, but it came on much more rapidly. No fever chills nausea or vomiting. No other complaints. Had a sigmoid resection for prior perforation.
Vital Signs: T: 36.6 °C, HR: 58, RR: 20, BP: 141/96, SpO2: 97%
Physical Exam: conversant but in moderate to severe distress from pain
°EYES: Clear without discharge. No icterus
°ABDOMEN: Soft, quite-tender. Positive guarding. Questionable rebound
Initial Diagnostic Testing:
What is the most accurate XR & CT interpretation?
- A) Ingested foreign body
- B) SBO
- C) Pepto-Bismol side effect
- D) Fatty Liver
- E) All of the above
SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT
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THE EMERGENCY MEDICINE POCKETBOOK TRIFECTA
- Emergency Medicine 1-Minute Consult, 5th edition
- A-to-Z EM Pharmacopoeia & Antibiotic Guide, 5th edition
- 8-in-1 Emergency Department Quick Reference, 5th edition
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ANSWER:
- A) Ingested foreign body
- B) SBO
- C) Pepto-Bismol side effect
- D) Fatty Liver
- E) All of the above – CORRECT