She denies any fever, vomiting, melena, bleeding, or diarrhea, but she said she does feel very bloated. She had a small bowel movement earlier today but then had a large bowel movement after the pain started. The head and neck exam, as well as the cardiopulmonary exams, were normal. The histological appearance was consistent with Echinococcus granulosus infection.
Moderately severe chronic cholecystitis with moderate fibrosis of the gallbladder wall and cholecystolithiasis were also present. The skin sutures were removed on the tenth postoperative day. As a result of wound dehiscence, the wound healed partly by second intention. The patient was free of symptoms.
The patient's subsequent progress was without complication. Discussion Upper abdominal pain is a common cause of presentation to general practitioners. Provided that the problem is new and that the clinical findings do not indicate a need for immediate hospitalisation, the cause of the pain can be satisfactorily established by history-taking and physical examination, where necessary supplemented by laboratory tests and imaging investigations sonography [ 1 ].
The SESAM-2 study found the most common diagnoses in patients presenting to general practitioners with abdominal pain to be gastritis and duodenitis Echinococcal disease is a rare cause of abdominal pain in Central Europe.
Examinee showed interest in the patient as a person i. Examinee demonstrated the ability to support the patient's emotions i. Examinee discussed initial diagnostic impressions with the patient. Examinee explained the management plan. Examinee used non-medical terms and provided reasons for planned steps in management.
However, in a symptomatic patient, medical management is limited to supportive care including possible antibiotic administration and surgical resection is required for definitive treatment. Keeping a large differential can help guide diagnosis and treatment options.
Although relatively rare, serious complications can arise in someone with Meckel's diverticulum and the definitive treatment is a surgical intervention for removal and repair. Meckel's diverticulum is often an incidental finding, and if found during surgery, removal is typically up to the discretion of the surgeon. Surgeons have determined certain guidelines to drive their decision to remove an asymptomatic diverticulum to prevent future complications.Electrolyte levels and kidney function testing are not helpful for diagnosis but can help guide treatment options. Computed tomography angiography CTA with runoff was ordered to evaluate lower extremity vasculature and perfusion, as well as abdominal vasculature and intra-abdominal organ pathology. Extra-abdominal causes such as abdominal muscle strain or a hernia and skin disorders such as herpes zoster viral infection are less likely. The patient was immediately started on fentanyl and intravenous IV fluids; she was also given IV ondansetron and promethazine for nausea. References 1.
Symptoms such as nausea, vomiting, pain after eating, pain radiating to the back, and improvement of the pain on leaning forward are common in acute pancreatitis. She denies any fever, vomiting, melena, bleeding, or diarrhea, but she said she does feel very bloated. Accessed March 27, This disease is generally asymptomatic at first. Finally, erosion of nearby intestinal mucosa or inflammation of the diverticulum itself can lead to perforation or the diverticulum itself can become inflamed leading to diverticulitis.
Laboratory findings associated with mesenteric ischemia include leukocytosis, metabolic acidosis, elevated lactate, and an elevated D-dimer. MMW Fortschr Med.
Case Study: Severe Right Upper Quadrant Pain A year-old woman presents with a 3-day history of severe right upper quadrant pain that worsens on inhalation.
Examinee showed interest in the patient as a person i. Even though this patient does not have jaundice and only has a low-grade fever , a positive Murphy sign is characteristic of acute cholecystitis, making this the most likely differential diagnosis. Overall, Meckel's diverticulum may be found incidentally on routine imaging or during a surgical procedure, or may only be recognized when complications arise.
Conclusion In the case described here abdominal pain, a common reason for presentation to general practitioners, was found to be due to a rare condition. Significant disease of the celiac and superior mesenteric arteries in asymptomatic patients: predictive value of Doppler sonography. Finally, erosion of nearby intestinal mucosa or inflammation of the diverticulum itself can lead to perforation or the diverticulum itself can become inflamed leading to diverticulitis. Provided that the problem is new and that the clinical findings do not indicate a need for immediate hospitalisation, the cause of the pain can be satisfactorily established by history-taking and physical examination, where necessary supplemented by laboratory tests and imaging investigations sonography [ 1 ]. Nonocclusive mesenteric ischemia.