Case Study Of Acute Abdomen

Abdomen: The lipases appeared unremarkable. The liver, spleen, gallbladder adrenals, kidneys, pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seemed consistent with acute appendicitis. All the structures of the abdomen appeared unremarkable. No free air was seen.

T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

In this study, out of 112 patients operated for acute non perforated appendicitis, 72 patients were male and 40 patients were female, a ratio of 1.8:1. The patients' age ranged from 18 to 55 years with a mean age of 26 years, the majority of cases lie in a range between 20-32 years. As shown in Table 1, there is no significant difference regarding patients' age, sex, medical comorbidities (diabetes, liver disease, renal disease, hyperlipidemia, heart disease), fever, leukocytosis, radiologic findings (appendiceal diameter, presence of free fluid) or operative time between the two groups.

It is always challenging to accurately diagnose abdominal pain in the primary care settings. An extensive knowledge of the anatomy and physiology could help narrow down possible causes of abdominal pain.

Patient F.C. is a 63-year-old African American male, who presents to the emergency department with intense left upper quadrant pain that radiates to his back and under his left shoulder blade; stating, “It feels like I have a knife in my stomach”. He reports the upper abdominal pain is intermittent, onset 3 weeks ago; however, the pain has been increasing in severity for the past four days. He states “he has been feeling very warm with episodes of nausea for the past 4 days” with a noted an 8-10 pound weight loss in the past 45 days. He denies any diarrhea or blood in his stool; however, he notes a reduction in the frequency of his bowel movements.

A 61 year old female was at Christus Spohn South Hospital to have a small bowel series done on September 15, 2016. She had prior radiographs from September 14, 2016, September 13, 2016 and September 12, 2016. She also had a CT scan of the abdomen and pelvis from September 8, 2016 and had a recent surgery on her abdomen. Radiographs of her abdomen showed staples and surgical clips along her midline in the epigastric region of her stomach. She was being evaluated for a possible bowel obstruction in the ileus.

Client’s abdomen on inspection looks flat and symmetric, without bulging, or visible masses, or any asymmetric shapes. Umbilicus is in midline and inverted without any sign of discoloration, inflammation, or hernia. Further, skin is smooth with even homogenous color, and multiple pigmented circumscribed brown macular and popular nevi (smaller than 1 cm), there are no visible veins, and when skin gently pinched and released, it was immediately returning to original position. No any pulsation observed, like from aorta in the epigastric area, no respiratory movements of any waves or peristalsis are visible. Pubic hair was distributed evenly, in diamond shape. The client observed with benign facial expression and slow even respiration.

A frequent pediatric problem in the emergency room is acute pain in the abdomen. The most common cause of surgery with acute abdominal pain in children is appendicitis. Sonography is proven to be effective in diagnosing appendicitis in children, while being cost-effective and free from radiation and contrast reactions. This study reviewed the effectiveness of sonography in diagnosing emergency room pediatric patients with acute abdominal pain. This retrospective-chart review used 775 pediatric patients within a 17-month study period. Researchers reviewed each patient’s ultrasound results for appendicitis and a final diagnosis of appendicitis was made based on the excised appendix’s histology report. The data presented a sensitivity of 96.4%

Twelve-year-old Hispanic male D.C. presented to Advocate Illinois Masonic Medical Center Emergency Department the morning of May 14, 2015, accompanied by his mother, for complaints of abdominal pain and vomiting that began that morning at 0100. While in the ED, D.C. complained of abdominal pain which he rated ten out of ten, so he was given a GI cocktail with Pepto-Bismol, as well as morphine for pain and Zofran for nausea, and his pain decreased to seven out of ten. Due to D.C.’s complaints of abdominal pain, which included his right lower quadrant, the ED physician caring for him ordered an ultrasound of his appendix. This ultrasound was non-diagnostic, as D.C.’s appendix was not visualized. Because he had a clinical

Patient might experience mild or sever pain, crampy, and aching that is similar to appendicitis. Passing of gas or stool elimination may reduce the adverse effect of pain. According to spivak & deSouza (2008), patient that are of high risk are those with the history of low-fiber diet, constipation, high intake of red meat, severe dehydration, and aging. The diagnostic tests are barium enema which determines number of diverticula, CBC indicates present of anemia, colonoscopy exposes present of diverticula, CT scan reveals changes in the colon wall, GI bleeding scan that identifies active bleeding, and CBC with differential reveals leukocytosis.

Women often face multiple issues when it comes to issues related to the abdomen. It may be excess weight after a pregnancy, pain and discomfort after a difficult delivery or a major surgery. Though not only confined to women, such cases are also frequent amongst men and aged individuals. Senior citizens face even more issues since the body takes much more time to recover.

Y.M. was admitted to Selma hospital after receiving diagnosis of having acute appendicitis, so she underwent a laparoscopic appendectomy. In summary, appendicitis is defined as, inflammation of the vermiform appendix as a result of an obstruction in the lumen of the appendix (Huether & McCance, 2012). Like all surgeries, even the smallest ones, complications can occur at any time during the intraoperative phases. During the post-operative period there is still potential for significant complications because the patient’s body still hasn’t reestablished its physiological equilibrium. Complications after an appendectomy can include: peritonitis, pelvic abscess, subphrenic abscess, and ileus (Huether & McCance, 2012). Aside from post-op complications

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

A 35-year-old man presented to the emergency department with acute right iliac fossa pain, haematochezia, fever, nausea and vomiting. On physical examination he had involuntary guarding of the right iliac fossa. He underwent to our Radiology department to perform a double-phase contrast enhanced abdominal/pelvic CT (64-slice) with the presumptive diagnosis of acute/complicated appendicitis. We found a true diverticulum at the antimesenteric border of the distal ileum measuring 5.5 cm of longitudinal diameter. He was located at approximately 3 cm of the ileocaecal valve. After the IV contrast, we saw active bleeding inside the diverticulum, with a large intra-luminal area of high attenuation (> 100 HU) representing the contrast media extravasation.

Objective of this study was to assess the rates of treatment failure, recurrence, post discharge perforation, mortality, total cost and length of stay in the non operative management of uncomplicated appendicitis. Retrospective analysis was conducted using the data from the California office of state wide health planning and development. Patient discharge data was included from 1995 to 2010. Only patients with ICD-9 diagnosis code of 540.9 were included. Admissions in the year 2009 and 2010 were not included to allow at least two years of follow up. Charleson index was calculated to assess patient’s comorbidities. A total of 2,31,678 patients with acute uncomplicated appendicitis were identified. 98.5% were managed with appendectomy. Only 3370 patients were managed nonoperatively and were included in the study for analysis. There was significant difference in the characteristics between non operative and surgical cohorts. Non operative patients were older and