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AbdominalPain

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16

An elderly woman with postprandial abdominal pain

An 84 year old woman presented with a five month history of central, recurrent, severe epigastric pain, which occurred about 20 minutes after eating. This was associated with nausea, occasional diarrhoea, and vomiting. She had experienced early satiety and weight loss over the last few months. Her medical history included myocardial infarction two years earlier. She also had a 40 pack year history of smoking. On examination, she was cachectic, but physical examination and digital rectal examination were otherwise unremarkable. Blood tests—including full blood count, liver functions tests, amylase, and renal function—were normal. Chest and abdominal radiographs, abdominal ultrasound, and computed tomography of the abdomen were unremarkable. Computed tomography angiography was performed (fig 1⇓).  
feeds.bmj.com
over 4 years ago
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14

A patient request for some “deprescribing”

A 52 year old man with a history of type 2 diabetes for 14 years and hypertension for nine years presented to his general practitioner. He was a non-smoker with an alcohol intake of eight units a week. He had been experiencing bloating, abdominal pains, and erratic motions for more than a year. Because he drove about 12 000 miles a year for his job he found the loose motions “a real worry.” He wondered whether any of his problems might be caused by his drugs and asked if he could cut down on any if they weren’t all needed. He admitted to being afraid that his diabetic control might deteriorate and that he might need insulin, like some of his relatives who also had diabetes.  
feeds.bmj.com
over 4 years ago
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6

Dr. Smith's ECG Blog: Epigastric Abdominal Pain and Vomiting

Instructive ECGs in Clinical Context ----Archives, Popular Posts, and an Index of all ECGs are down the right-hand side.  
hqmeded-ecg.blogspot.com
over 4 years ago
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17

Medical Expulsion Therapy in Ureteral Colic: An Update - R.E.B.E.L. EM - Emergency Medicine Blog

Back in August 2014, we posted a review on medical expulsion therapy (MET) in patients with renal colic, but since then 2 new trials have been published, so we thought a brief review of each of these articles and updated recommendations were warranted.  
rebelem.com
over 4 years ago
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7

Interventions for preventing and treating kidney disease in Henoch-Schönlein Purpura | Cochrane

Henoch-Schönlein Purpura (HSP) causes inflammation of small blood vessels in children and affects approximately 20/100,000 children annually. Symptoms and signs include a purpuric skin rash (which comprises small spots and larger bruises), abdominal pain, gastrointestinal bleeding, joint pain and swelling, facial swelling and evidence of kidney disease with blood and protein in the urine. Kidney disease occurs in about one third of children with HSP. In the majority this is mild (small amounts of blood in the urine only) and resolves completely but a few children have persistent kidney disease that can progress to kidney failure.  
cochrane.org
over 4 years ago
Sinaiem dark
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16

p-or-iup

A G1P0 10-week pregnant female presents to the ED with lower abdominal pain and vaginal spotting. She’s had no prenatal care. Being the highly motivated resident that you are, before even the urine is collected and the pregnancy is verified, you bring the ultrasound machine bedside and see this:  
sinaiem.org
over 4 years ago
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Abdo pain week 1 – a general approach – Don't Forget the Bubbles

Abdominal pain accounts for ~ 5% of all presentations to paediatric emergency departments. Surgery is only required in 1-7% of these and there is no specific diagnosis in up to 15%.  
dontforgetthebubbles.com
over 4 years ago
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2

Belly ache and Rigler's Sign - INTENSIVE

Abdominal pain with an abnormal abdominal x-ray that is Rigler's sign positive.  
intensiveblog.com
over 4 years ago
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Type I interferons for treatment of active ulcerative colitis | Cochrane

Ulcerative colitis (UC) is a long-term (chronic) inflammatory bowel disease characterized by abdominal pain, bloody diarrhea, and a need to hurry to the toilet to pass feces (fecal urgency).  
cochrane.org
over 4 years ago
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Imaging Case of the Week 171

The following x-rays are from a 30 year old with sudden onset of severe abdominal pain. What two abnormalities can be observed? One is acute and the other, an incidental pathology.  
emergucate.com
about 4 years ago
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12

Emergency Medicine Literature of Note: A Very Odd Look at CT In the ED

Interesting summary, thanks. Although bouncebacks were not prevented, I'm curious whether CTs impacted how patients were treated on their return. For example, were they appropriately or inappropriately stratified into low risk ("3rd visit for abdominal pain after a negative CT...")?  
emlitofnote.com
about 4 years ago
Static.www.bmj
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Characteristic sign of a colonic submucosal lesion

A 58 year old woman presented with lower abdominal pain, constipation for three months, and intermittent small bleeds per rectum. She had no abdominal distension, vomiting, weight loss, or family history of colonic cancer. She had hypertension and type 2 diabetes and was taking regular drugs. Blood test results were unremarkable. Ultrasound imaging of her abdomen was normal. …  
feeds.bmj.com
about 4 years ago
Static.www.bmj
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1

Characteristic sign of a colonic submucosal lesion

A 58 year old woman presented with lower abdominal pain, constipation for three months, and intermittent small bleeds per rectum. She had no abdominal distension, vomiting, weight loss, or family history of colonic cancer. She had hypertension and type 2 diabetes and was taking regular drugs. Blood test results were unremarkable. Ultrasound imaging of her abdomen was normal. …  
feeds.bmj.com
about 4 years ago
Static.www.bmj
0
2

Characteristic sign of a colonic submucosal lesion

A 58 year old woman presented with lower abdominal pain, constipation for three months, and intermittent small bleeds per rectum. She had no abdominal distension, vomiting, weight loss, or family history of colonic cancer. She had hypertension and type 2 diabetes and was taking regular drugs. Blood test results were unremarkable. Ultrasound imaging of her abdomen was normal. …  
feeds.bmj.com
about 4 years ago
Static.www.bmj
0
0

Characteristic sign of a colonic submucosal lesion

A 58 year old woman presented with lower abdominal pain, constipation for three months, and intermittent small bleeds per rectum. She had no abdominal distension, vomiting, weight loss, or family history of colonic cancer. She had hypertension and type 2 diabetes and was taking regular drugs. Blood test results were unremarkable. Ultrasound imaging of her abdomen was normal. …  
feeds.bmj.com
about 4 years ago
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1

Imaging Case of the Week 173

The following abdominal x-rays are from a 60 year old with abdominal pain and distension. What two radiological signs can be seen?  
emergucate.com
about 4 years ago
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1

Citrate salts for preventing and treating calcium containing kidney stones in adults | Cochrane

Kidney stones are one of the most common disorders of the urinary tract. They typically affect people aged 40 to 60 years of age and are twice as common in men than women although recent data suggest the risks are more equal. Calcium stones are the most common type of kidney stone and occur in two major forms: calcium oxalate and calcium phosphate. Kidney stones can cause severe abdominal pain and may require urgent treatment; they are one of the main causes of unscheduled admissions in urological practice.  
cochrane.org
about 4 years ago
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A premenopausal woman with abdominal discomfort and iron deficiency anaemia

A 48 year old premenopausal woman presented to our clinic with a 12 month history of intermittent abdominal discomfort associated with bloating, constipation, and weight loss of 6.3 kg. Her medical history included chronic iron deficiency anaemia, vitamin D deficiency, and episodes of fresh rectal bleeding caused by haemorrhoids, which required sclerotherapy. She had undergone a diagnostic laparoscopy for abdominal pains, which did not detect any abnormalities. There was no family history of colorectal cancer. On examination she looked well, weighed 50 kg, with a body mass index of 20. Her abdomen was soft, non-tender, and without palpable masses. The results of a digital rectal examination were normal. Routine blood tests showed iron deficiency anaemia, with haemoglobin 109 g/L (reference range 117-155), mean corpuscular volume 80.6 fL (80-100), mean corpuscular haemoglobin 27.3 pg/cell (27-33), and ferritin 4 ng/mL (10-232)  
feeds.bmj.com
about 4 years ago
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0

A premenopausal woman with abdominal discomfort and iron deficiency anaemia

A 48 year old premenopausal woman presented to our clinic with a 12 month history of intermittent abdominal discomfort associated with bloating, constipation, and weight loss of 6.3 kg. Her medical history included chronic iron deficiency anaemia, vitamin D deficiency, and episodes of fresh rectal bleeding caused by haemorrhoids, which required sclerotherapy. She had undergone a diagnostic laparoscopy for abdominal pains, which did not detect any abnormalities. There was no family history of colorectal cancer. On examination she looked well, weighed 50 kg, with a body mass index of 20. Her abdomen was soft, non-tender, and without palpable masses. The results of a digital rectal examination were normal. Routine blood tests showed iron deficiency anaemia, with haemoglobin 109 g/L (reference range 117-155), mean corpuscular volume 80.6 fL (80-100), mean corpuscular haemoglobin 27.3 pg/cell (27-33), and ferritin 4 ng/mL (10-232)  
feeds.bmj.com
about 4 years ago
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1

A premenopausal woman with abdominal discomfort and iron deficiency anaemia

A 48 year old premenopausal woman presented to our clinic with a 12 month history of intermittent abdominal discomfort associated with bloating, constipation, and weight loss of 6.3 kg. Her medical history included chronic iron deficiency anaemia, vitamin D deficiency, and episodes of fresh rectal bleeding caused by haemorrhoids, which required sclerotherapy. She had undergone a diagnostic laparoscopy for abdominal pains, which did not detect any abnormalities. There was no family history of colorectal cancer. On examination she looked well, weighed 50 kg, with a body mass index of 20. Her abdomen was soft, non-tender, and without palpable masses. The results of a digital rectal examination were normal. Routine blood tests showed iron deficiency anaemia, with haemoglobin 109 g/L (reference range 117-155), mean corpuscular volume 80.6 fL (80-100), mean corpuscular haemoglobin 27.3 pg/cell (27-33), and ferritin 4 ng/mL (10-232)  
feeds.bmj.com
about 4 years ago