Abdominal Pain Flashcards
ectopic pregnancy plan
beta hCG, transabdominal/transvaginal ultrasound
ectopic pregnancy pt explanation
It sounds like you may have an ectopic pregnancy. This is when a fertilized egg implants and grows outside of the uterus, most often in the fallopian tubes. This can be painful as there isn’t enough space for an embryo to grow here. It can also be dangerous if the fallopian tube ruptures and can cause a lot of bleeding. What we can do is get a blood test (HcG) as well as an ultrasound imaging test to confirm this.
appendicitis plan
CT scan to rule out if dx uncertain, CBC (neurophilic leukocytosis), give IV fluids and abx, surgery likely
appendicitis pt explanation
It sounds like you have acute appendicitis. Your appendix is a finger shaped pouch that comes out from your colon on the R side. When there is inflammation or infection here, you can get intense pain. It’s important that we treat this right away because if untreated, the appendix can rupture which can spread infection throughout your abdomen. You should go to the emergency room right away - we will make sure you get there safely. When you get there they will likely do a CT scan and some blood tests (CBC) to look for signs of infection. Then they will likely prepare you for surgery to remove your appendix and can walk you through those next steps.
cholelithiasis/cholecystitis plan
send to ER, get ultrasound and initial labs (LFTs, amylase, lipase), may need surgery. Note: choledocholithiasis is when blocks common bile duct (may have jaundice, elevated alk phos, amylase or lipase)
cholelithiasis/cholecystitis pt explanation
It sounds like you have gallstones. Normally your gallbladder stores and secretes bile which helps break down fatty foods. However, sometimes you can develop stones (like a kidney stone) that can block this secretion and be painful. You should go to the emergency room right away - we will make sure you get there safely. They will first evaluate where exactly the blockage might be with some imaging tests, like an ultrasound. They may also do some blood tests to make sure that what is happening is related to your gallbladder.
acute pancreatitis plan
send to ER, will need to be admitted. Will do US, CT. Labs: LFTs, amylase, lipase
acute pancreatitis pt explanation
It sounds like you have pancreatitis. Your pancreas is an organ in your abdomen that produces enzymes which help digest your food and help your body process sugar. Pancreatitis is when the pancreas gets inflamed or irritated and it can lead to these enzymes digesting your pancreas itself. You should go to the emergency room right away - we will make sure you get there safely. You will likely need to be admitted to the hospital. They will do some imaging tests, like an ultrasound of your abdomen or a CT scan, and they will do some blood tests to check the function of your pancreas.
large bowel obstruction plan
get imaging (CT or xray) to confirm, then likely surgery
large bowel obstruction pt explanation
It sounds like you may have a bowel obstruction. This is when something is blocking your intestines from moving food and fecal matter through properly. You will likely need to be admitted to the hospital. You will need to have some imaging, like a CT scan and Xray, and then they may decide to perform surgery to correct this. They will be able to walk you through those next steps as needed at the hospital.
small bowel obstruction plan
labs (CBC, chem7 to check electrolytes, blood gas), imaging (CT) to confirm then may need surgery
small bowel obstruction pt explanation
It sounds like you may have a bowel obstruction. This is when something is blocking your intestines from moving food and fecal matter through properly. You will likely need to be admitted to the hospital. You will need to have some imaging, like a CT scan and Xray, and then they may decide to perform surgery to correct this. They will be able to walk you through those next steps as needed at the hospital.
acute mesenteric ischemia plan
CT angiogram, then revascularization and surgery
acute mesenteric ischemia pt explanation
It sounds like you may have mesenteric ischemia. This is where narrowed or blocked arteries restrict the blood flow to your small intestine in your abdomen. When this happens, we get concerned that this decreased blood flow could cause permanent damage. You should go to the emergency room right away - we will make sure you get there safely. They will likely first do an imaging test called a CT angiogram to learn more about what is happening. They may need to perform surgery or another procedure to help restore blood flow to your intestines.
ischemic colitis plan
colonoscopy, then supportive therapy
ischemic colitis pt explanation
It sounds like you may have ischemic colitis. This is an inflammatory condition in the large intestine or colon where there isn’t enough blood flow, often due to a buildup of plaque in the arteries supplying blood to that area. What we can do is set you up to get a colonoscopy to evaluate this further.
abdominal aortic aneurysm plan
screening + elective surgery if necessary
abdominal aortic aneurysm pt explanation
It sounds like you may have an abdominal aortic aneurysm. This is when a lower portion of your body’s main artery, the aorta, gets weakened and bulges. What we worry about with AAAs is that this aneurysm could rupture, which can be dangerous. For next steps, we can do an imaging test, an ultrasound, to take some images of your aorta. Then depending on what those results say, we can have a conversation about surgery to repair this to prevent the aneurysm from bursting.
nephrolithiasis plan
US and CT to confirm, pain control, stone passage
nephrolithiasis pt explanation
It sounds like you have kidney stones. This can happen when the concentration of certain salts are unbalanced in the urine. This causes stones to form which can then block the passage of urine and be very painful. What we can do is help you with pain management and give you some medications like ibuprofen for pain and to help with passing the stone through your urine.
IBS plan
need to do some tests to rule out other more serious causes
IBS pt explanation
It sounds like you have IBS. This is when you have abdominal pain and altered bowel habits. Sometimes these symptoms can also be caused by anemia, when you have a decrease in your red blood cells, so we can order a blood test to check that too. We can also do another blood test to check for other inflammatory diseases.
chronic mesenteric ischemia plan
CT angiogram, revascularization surgery
chronic mesenteric ischemia pt explanation
It sounds like you may have chronic mesenteric ischemia. This is when plaque builds up in the major arteries — including the celiac and superior mesenteric arteries — that supply blood to the small intestine or small bowel. For next steps, we can do an imaging test, called a CT angiogram. This will involve injecting contrast dye and then looking at the vessels to see if we can find any blockages. From there we can explore other options to help manage this pain, which may mean a procedure to unblock those arteries.
