HonorsMentorship

What are the five potentially fatal causes of abdominal pain?

1. MI(myocardial infarction), AAA(abdominal aortic aneurysm), ruptured ectopic pregnancy, perforated viscus, mesenteric ischemia

2. After learning these causes of abdominal pain, I have been able to pick up more of what is going on in the Emergency Room. MI’s for example, can cause pain in the chest, arms, or abdomen.

What factors are taken into account when a patient has a complaint of abdominal pain?

1. History of present illness, age/sex of patient, choroiditis of pain, prior history of known diseases and surgeries

2. This is something I see Doctor Ball ask every question every day. The choroiditis of pain is basically a scale from one to ten of how much pain the patient is in.

How do you narrow down the problem to get an accurate diagnosis?

1. Use tests and history to exclude most dangerous causes, investigate further and respond to them to further narrow the list of possibilities.

2. Some of the first things we ask patients in the ER, are questions about history. We then order the necessary tests to determine what exactly is the cause of the pain.

What makes you different from a general physician at a doctor’s office?

1. Think “backwards”, ie; address and exclude the most dangerous possible causes of symptoms first. Also, ER Doctors do not become too involved with investigating chronic of non-emergent complaints.

2. Looking at my third annotated bibliography, I noticed something similar to what Doctor Ball said about not becoming too involved with investigating non-emergent complaints. Patients that are not dying need to be sent to their primary care doctor.

How often do patients come in with complaints of abdominal pain?

1. Very common complaint. Multiple patients daily.

2. We had a day where that is pretty much all we saw-- abdominal pain. The causes of the pain ranged from MI’s, to appendicitis, to myalgias.

What percentage of ER patients with abdominal pain leave without a specific diagnosis?

1. Normally 30%.

2. Many patients leave with acute abdominal pain that we do not spend time investigating and instead send them to their primary care doctors.

What tools are used in evaluating patients with Abdominal Pain?

1. History/experience. Blood tests, Xrays, CT, Ultrasound, Urine test.

2. Looking and blood and urine tests, it can be seen if there is a chemical imbalance in the patient that would make them feel bad.

What are the treatments for the five fatal diseases?

1. 1. MI- Open involved artery (cath lab)

   2. AAA- Surgery

   3. Ruptured ectopic pregnancy- surgery

   4. Perforated viscus- surgery

   5. Mesenteric Ischemia- surgery/blood thinner

2. Notice how many of these require surgery. All of these causes are complicated and lethal if not treated immediately. These are what doctors look for first when a patient enters the ER.

What are the common non-lethal causes of Abdominal Pain?

1. Ulcer disease, GERD, Pancreatitis, SBO, Appendicitis, Gallbladder Disease(cholecystitis, obstruction), gastroenteritis, colitis, diverticulitis, pyelonephritis

2. All of these diseases  can be very painful, and although they are not immediately lethal, it is important for them to be recognized as soon as possible. Every case in the ER should be taken seriously as to not rule out potentially fatal issues prematurely.

What are their treatments?(from question 9)

1. Depending on the condition it can be surgery or medication. For example, appendicitis almost always requires the removal of the appendix whereas diverticulitis sometimes requires surgery but can often be fixed with medication and/or change of diet.