Triage: Abdominal pain. treated recently for constipation. now not able able to urinate. States Last “normal” urination was Friday night. On GoLytely for the constipation, since then has had diarrhea. No N/V
History of Present Illness: A man in his early 70’s comes in for abdominal distention for at least a week if not a month or more but worse for the last week and associated diarrhea after taking GoLytely for constipation. He had a CT about a day ago that was read out as normal but we reviewed the images and it does look like he has distended bowel there he is also complaining of decreased urination but unclear if he is having more retention or just feels deep hydrated which he says he does and that is why he is urinating less. No pain fever vomiting or other complaints.
Vital Signs: HR 88, BP 128/77, RR 20, pulse ox 97%
Physical Exam:
°LUNGS: Unlabored respirations.
°ABDOMEN: Soft, non-tender. No guarding. No rebound. Extremely distended and somewhat tympanitic
°GENITOURINARY: No CVAT
Initial Diagnostic Testing:
What is the most likely knee injury?
- A) SBO
- B) LBO
- C) Pseudoobstruction
- D) Perforation
- E) None of the above
SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT
<<<<<<<<<<<<<<<<<<<<< ADVERTISEMENT & SPACER >>>>>>>>>>>>>>>>>>>>>
****************************************************************************
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
***************************************************************************
***************************************************************************
<<<<<<<<<<<<<<<<<<<<<<<<< END SPACER >>>>>>>>>>>>>>>>>>>>>>>>>
ANSWER:
1-Minute Consult on this topic: Click HERE and scroll down
CASE CONCLUSION: Oglilvie’s diagnosed. Seen by GI after admission. Treated with neostigmine but developed bradycardia from treatment.