New to Meducation?
Sign up
Already signed up? Log In
view moderators

AbdominalPain

Category

Preview
0
13

Budesonide for treatment of people with active Crohn's disease. | Cochrane

What is Crohn's disease? Crohn's disease is a debilitating long-term (chronic) inflammatory bowel disease that can affect any part of the gastrointestinal tract from mouth to anus. Symptoms include abdominal pain, non-bloody diarrhea and weight loss. The most common initial treatment of the Crohn's disease is oral steroid therapy. Unfortunately, traditional steroids are usually absorbed into the body and cause significant unwanted side effects. These may include but are not limited to weight gain, diabetes, growth retardation, acne, mood instability, and high blood pressure. When people with Crohn's disease are experiencing symptoms of the disease it is said to be ‘active’; periods when the symptoms stop are called ‘remission’.  
cochrane.org
over 5 years ago
Sinaiem dark
0
3

burning-up

62 y/o M PMH of hep C cirrhosis, HTN, and anemia presents with fever to 101.6 and diffuse abdominal pain. Your patient has jaundice and abdominal distension and tenderness with shifting fluid wave. You work him up with labs, including a tap to rule out SBP. Can you safely use tylenol to control his fever?  
sinaiem.org
over 5 years ago
Preview
0
5

Emergency Medicine Literature of Note: Finally, an End to Tamulosin for Renal Colic?

Great post Ryan. Keep up the good work.I particularly like your comment about the notion p-values. Intellectually there is really no difference in a p-value of 0.04 and 0.06. But we pretend that this dichotomous cut-off has some holy meaning. There are those that advocate abandoning p-values all together as they are so often misunderstood and misinterpreted. 95% confidence intervals are probably a better focus.Enjoy the Sunnyside.  
emlitofnote.com
over 5 years ago
5c99e05daddc3236a7babdf20470e79544124ab6815980014389844
1
76

Acute Abdomen

Helped me see it as a whole, thought it might help you too:)  
Katerina Efstathiou
over 5 years ago
Preview
1
30

Recognition of Common Childhood Malignancies - American Family Physician

Although cancer has an annual incidence of only about 150 new cases per 1 million U.S. children, it is the second leading cause of childhood deaths. Early detection and prompt therapy have the potential to reduce mortality. Leukemias, lymphomas and central nervous system tumors account for more than one half of new cancer cases in children. Early in the disease, leukemia may cause nonspecific symptoms similar to those of a viral infection. Leukemia should be suspected if persistent vague symptoms are accompanied by evidence of abnormal bleeding, bone pain, lymphadenopathy or hepatosplenomegaly. The presenting symptoms of a brain tumor may include elevated intracranial pressure, nerve abnormalities and seizures. A spinal tumor often presents with signs and symptoms of spinal cord compression. In children, lymphoma may present as one or more painless masses, often in the neck, accompanied by signs and symptoms resulting from local compression, as well as signs and symptoms of systemic disturbances, such as fever and weight loss. A neuroblastoma may arise from sympathetic nervous tissue anywhere in the body, but this tumor most often develops in the abdomen. The presentation depends on the local effects of the solid tumor and any metastases. An abdominal mass in a child may also be due to Wilms' tumor. This neoplasm may present with renal signs and symptoms, such as hypertension, hematuria and abdominal pain. A tumor of the musculoskeletal system is often first detected when trauma appears to cause pain and dysfunction out of proportion to the injury. Primary care physicians should be alert for possible presenting signs and symptoms of childhood malignancy, particularly in patients with Down syndrome or other congenital and familial conditions associated with an increased risk of cancer.  
aafp.org
over 5 years ago
Sinaiem dark
0
5

bloated-and-upset

47 y/o female PMH appendectomy presents with three days of worsening abdominal pain and constipation. Over the past day she has had persistent vomiting. She appears ill and has a diffusely tender abdomen. You quickly order labs and an obstructive series with upright chest XR with concern for a perforated viscus. To your surprise the CXR shows no signs of air under the diaphragm. Are there other signs of pneumoperitoneum could you look for on abdominal films?  
sinaiem.org
over 5 years ago
Preview
0
4

Ustekinumab and briakinumab for the treatment of active Crohn's disease | Cochrane

What is Crohn's disease? Crohn's disease is a long-term (chronic) inflammatory bowel disease that can affect any part of the gastrointestinal tract from mouth to anus. Symptoms include abdominal pain, non-bloody diarrhea and weight loss.  
cochrane.org
over 5 years ago
Preview
0
9

A young woman with recurrent perianal sepsis

A 23 year old woman had been experiencing cramping abdominal pain, alternating diarrhoea and constipation, and episodic blood per rectum for four months. An earlier colonoscopy showed proctitis, which was thought to be indicative of underlying inflammatory bowel disease, and she was started on oral and topical mesalazine. In the following months she was admitted twice with acute perianal sepsis, which required examinations under anaesthesia and drainage of an intersphincteric abscess. She later presented after feeling generally unwell for four days with “flu-like” symptoms and perianal pain. On examination she had tenderness and fluctuance in the region of the right ischial tuberosity, with an external fistula opening visibly in the perineum. Her blood tests show mild neutrophilia (9.40×109/L, reference range 2-7.5) and mildly raised C reactive protein (380.96 nmol/L (40 mg/L), 0-95.24 (0-10) only.  
feeds.bmj.com
over 5 years ago
Preview
0
8

A young woman with recurrent perianal sepsis

A 23 year old woman had been experiencing cramping abdominal pain, alternating diarrhoea and constipation, and episodic blood per rectum for four months. An earlier colonoscopy showed proctitis, which was thought to be indicative of underlying inflammatory bowel disease, and she was started on oral and topical mesalazine. In the following months she was admitted twice with acute perianal sepsis, which required examinations under anaesthesia and drainage of an intersphincteric abscess. She later presented after feeling generally unwell for four days with “flu-like” symptoms and perianal pain. On examination she had tenderness and fluctuance in the region of the right ischial tuberosity, with an external fistula opening visibly in the perineum. Her blood tests show mild neutrophilia (9.40×109/L, reference range 2-7.5) and mildly raised C reactive protein (380.96 nmol/L (40 mg/L), 0-95.24 (0-10) only.  
feeds.bmj.com
over 5 years ago
Preview
0
8

Podcast#4: Getting Un-Stoned (Renal Colic and Alpha Blockers)

Vincendeau et al. Tamsulosin Hydrochloride vs Placebo for Management of Distal Ureteral Stones. Arch Intern Med. 2010;170(22):2021­2027 PMID: 21149761  
thesgem.com
over 5 years ago
Preview
0
19

Podcast #12: Oh Dance-a-tron (Ondansetron for Pediatric Vomiting)

Dehydration in children is a common presentation to the emergency department. A main cause of dehydration in this age group is gastroenteritis which is charaterized by acute onset diarrhea with or without nausea, vomiting, fever and abdominal pain. The scope of the problem was quantified by Glass in 1991. This study showed the following:  
thesgem.com
over 5 years ago
Preview
0
10

SGEM#32: Stone Me (Fluids and Diuretics for Renal Colic)

Case Scenario: A 46yo man presents to the emergency department doing the renal colic shuffle (not the Harlem Shake). He has a history of kidney stones. Nothing in his physical examination or investigations suggest anything other than another renal colic attack. He wants to know if there is a way to flush the stone out.  
thesgem.com
over 5 years ago
Preview
0
20

SGEM#71: Like a Rolling Kidney Stone (A Systematic Review of Renal Colic)

Classic Guest Skeptics: Dr. Anthony (Tony) Seupaul Chairman of the Department of Emergency Medicine, University of Arkansas for Medical Sciences and Dr. Joshua Hughes one of his star residents.  
thesgem.com
over 5 years ago
Preview
0
11

SGEM#97: Hippy Hippy Shake – Ultrasound Vs. CT Scan for Diagnosing Renal Colic

Guest Skeptic: Dr. Tony Seupaul and Dr. Spencer Wright. Tony is the Chairman of the Department of Emergency Medicine, University of Arkansas.  
thesgem.com
over 5 years ago
Preview
0
15

A young woman with recurrent perianal sepsis

A 23 year old woman had been experiencing cramping abdominal pain, alternating diarrhoea and constipation, and episodic blood per rectum for four months. An earlier colonoscopy showed proctitis, which was thought to be indicative of underlying inflammatory bowel disease, and she was started on oral and topical mesalazine. In the following months she was admitted twice with acute perianal sepsis, which required examinations under anaesthesia and drainage of an intersphincteric abscess. She later presented after feeling generally unwell for four days with “flu-like” symptoms and perianal pain. On examination she had tenderness and fluctuance in the region of the right ischial tuberosity, with an external fistula opening visibly in the perineum. Her blood tests show mild neutrophilia (9.40×109/L, reference range 2-7.5) and mildly raised C reactive protein (380.96 nmol/L (40 mg/L), 0-95.24 (0-10) only.  
feeds.bmj.com
over 5 years ago
Sinaiem dark
0
18

lump-in-my-throat

A 19-year-old-male with no known past medical history, presents in progressive respiratory distress shortly after undergoing a tooth extraction about 6 hours prior to presentation. Symptoms began initially as “a lump in his throat” and difficulty swallowing, but eventually progressed to mild dyspnea after 1-2 hours. Denies FB or allergies. On arrival he appears anxious and is breathing at 18 breaths per minute with an O2 saturation of 100%. There is no stridor at presentation. There is no intra-oral, facial, or obvious neck swelling. There is no skin involvement or abdominal pain, nausea, vomiting or diarrhea. You suspect allergic reaction and give IM epi, IV steroids, benadryl and pepcid. ENT is consulted for scope.  
sinaiem.org
over 5 years ago
Preview
0
12

Ultrasound Leadership Academy: Ultrasound for Renal Colic

New evidence from a recent NEJM article, evaluating US vs CT for initial work up of suspected renal colic, found no difference in adverse outcomes. This suggests that a more conservative imaging strategy, beginning with renal ultrasound, may be the right place to start. Learn how here.   
emcurious.com
over 5 years ago
Preview
0
80

Make the Diagnosis: Abdominal pain, racing heart

<p><b>Case Study:</b> A patient presents to the emergency department with severe abdominal pain, tachycardia, and an elevated serum lactate level. At laparotomy, a segment of ischemic bowel is discov  
medpagetoday.com
over 5 years ago
Preview
0
32

Mesenteric Ischemia & Pancreatitis

4 diagnoses comprise Mesenteric Ischemia, value of serum lactate, difficult post-ERCP abdominal pain patient, Pancreatitis BISAP score, amylase vs lipase  
emergencymedicinecases.com
over 5 years ago