Tieman CIS- abdominal pain Flashcards
what does the psoas sign tell us?
there is inflammation over the psoas muscle.
it is retroperitoneal, behind the R/ L colon
diffuse abdominal pain without much in the way of peritoneal/ abdominal findings
be concerned about ischemia from an embolus
treatment for sigmoid diverticulitis
bowel rest, IV fluids and IV imipenem
AFTER that, *** do a colonoscopy
what do we always do with a female who comes in with abdominal pain
pregnancy test
episodic pain before periods with neurological component, palpitations, tachycardia
no symptoms until puberty beginning
classic for intermittent porphyria
test and treatment for porphyria
urinary porphorins
treat with IV glucose
(fasting makes it worse)
dullness to percussion in the left posterior basilar region of the chest wall. What do we think of this?
pleural effusion of some kind
left pleural effusion often coincides with acute pancreatitis
3 things (need 2) for dx of pancreatitis
amylase and lipase elevated 3x normal (150)
ab pain consistent with pancreas location
diagnostic imaging consistent with pancreatitis
most common causes of pancreatitis in US
gallstones
alcohol
(some others: trauma, drugs, hyperlipidemia)
an important lab to get with pancreatitis
calcium levels; they typically get hypocalcemia
who dies from pancreatitis?
people who have severe organ dysfunction
there are different criteria people have come up with
treatment of acute pancreatitis?
IV resuscitation
bowel rest
low fat diet soon
pancreas guy gets better but then worse. What gives?
pancreatic absess
treat with IV abx
drain percutaneously
if necessary, after a while take to surgery
some things that go with chronic pancreatitis
smoking
obesity/ diabetes
history of alcohol abuse
pain that radiates to the back, waxes and wanes
Puestow procedure
is a surgical technique used in the treatment of chronic pancreatitis. It involves a side-to-side anastomosis of the pancreatic duct and the jejunum
