COMMON COMPLAINTS: Abdominal Pain

Question 1

6 wk hx of epigastric pain. Most severe after eating and is releived by OTC tums. Does not smoke and has HTN controlled w/HCTZ. No occult blood in stool test. What dx are you considering and what dx tests will help?

Answer 1

-Peptic Ulcer disease= #1 most likely, most common cause is infectio w/ Helocobactori pylori so you can so an antibody assay to assess for this

-Another Dx could be GERD, esophageal pH monitoring

-Cholecystitis, abdominal US
-Pancreatitis, note this would present likely w/epigastric pain radiating to the back, emesis/nausea. Look at serum amylase

Question 2

Pediatric pt presenting with acute abdominal pain in the RLQ with no fever or signs of infection on CBC , has evidence of microcytic anemia. You should consider ordering what and why?

Answer 2

Order a blood smear because this patient might have sickle cell

Noninfection, abdominal pain, microcytic anemia in a kid–> maybe SCD!