A 33-year-old Man with Abdominal Pain
学术急诊医学档案,
卷 4 编号 3 (2016),
1 八月 2016
,
第 166-168 页
https://doi.org/10.22037/aaem.v4i3.244
摘要
A 33-year-old man presented to the emergency department ED) with complaint of 2-day history of abdominal pain. His pain developed with gradual onset prominently in epigastric area after eating dried mushrooms. The pain was diffuse, persistent, radiating to the back and aggravated by meal. He had been tolerating only liquids and had complaints of nausea and vomiting. He had no history of diabetes mellitus, hypertension, alcohol consumption, malignancy, or prior surgery. On arrival his blood pressure was 128/72 mmHg, with a heart rate of 101 beats/minute and a respiratory rate of 20 breaths/minute. He was afebrile. Physical examination revealed diffuse abdominal distention, hyper-pitched bowel sounds, and tenderness more marked over the umbilicus with no guarding or rebound tenderness. A complete blood cell count showed the following: leukocyte count 12600 /mm3; segmented neutrophils 90%; hemoglobin level of 14 mg/dl; hematocrit 30%; and platelet 420000/µL. Other laboratory studies included: glucose 101 mg/dL; serum urea nitrogen 45 mg/dL; serum creatinine 2.0 mg/dL; sodium 148 mEq/L; potassium 3.1 mEq/L; serum glutamic oxaloacetic transaminase (SGOT) 38 U/L and lipase 30 U/L. Figure 1 shows patient’s plain upright abdominal X-ray as well as coronal and axial cuts of abdominal CT scan.##submission.howToCite##
参考
Jackson PG, Raiji M. Evaluation and management of intestinal obstruction. American family physician. 2011;83(2).
Kariman H, Shojaee M, Sabzghabaei A, Khatamian R, Derakhshanfar H, Hatamabadi H. Evaluation of the Alvarado score in acute abdominal pain. Ulus Travma Acil Cerrahi Derg. 2014;20(2):86-90.
Majidi A, Mahmoodi S, Baratloo A, Mirbaha S. Atypical Presentation of Massive Pulmonary Embolism, a Case Report. Emergency. 2014;2(1):46.
Forouzanfar M, Hatamabadi H, Hashemi B, Majidi A, Baratloo A, Shahrami A, et al. Outcome of nonspecific abdominal pain in the discharged patients from the emergency department. Journal of Gorgan University of Medical Sciences. 2014;16(2):62-8.
Schwab DP, Blackhurst DW, Sticca RP, Laws II HL. Operative acute small bowel obstruction: Admitting service impacts outcome/Discussion. The American surgeon. 2001;67(11):1034.
Mullan CP, Siewert B, Eisenberg RL. Small bowel obstruction. American Journal of Roentgenology. 2012;198(2):W105-W17.
Shin C-I. Small Bowel Obstruction. Radiology Illustrated: Gastrointestinal Tract: Springer; 2015. p. 325-49.
Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemelis D, Giannopoulos P, et al. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World journal of Gastroenterology. 2007;13(3):432.
Gümüs M, Kapan M, Önder A, Tekbas G, Yagmur Y. An unusual cause of small bowel obstruction: dried apricots. JPMA-Journal of the Pakistan Medical Association. 2011;61(11):1130.
Ooi S, Hong K. Small bowel obstruction caused by dried apple. International journal of surgery case reports. 2015;10:154-7.
Bedioui H, Daghfous A, Ayadi M, Noomen R, Chebbi F, Rebai W, et al. A report of 15 cases of small-bowel obstruction secondary to phytobezoars: predisposing factors and diagnostic difficulties. Gastroenterologie Clinique et biologique. 2008;32(6):596-600.
Thompson JS. Contrast radiography and intestinal obstruction. Annals of surgery. 2002;236(1):7-8.
Xu G, Guo Y. Computed Tomography Findings of Small Bowel Obstruction due to Bezoar Impaction: A Case Series. Emergency Medicine: Open Access. 2012;2012.
Wang P-Y, Wang X, Zhang L, Li H-F, Chen L, Wang X, et al. Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography. World journal of gastroenterology: WJG. 2015;21(33):9774.
Porter DJ, Cosgrove C, Middleton E. An Unusual Case of Small Bowel Obstruction. Journal of Medical Cases. 2015;6(11):517-9.
Paulson EK, Thompson WM. Review of small-bowel obstruction: the diagnosis and when to worry. Radiology. 2015;275(2):332-42.
- 摘要 ##plugins.themes.ojsPlusA.frontend.article.viewed##: 398 ##plugins.themes.ojsPlusA.frontend.article.times##
- PDF (English) ##plugins.themes.ojsPlusA.frontend.article.downloaded##: 203 ##plugins.themes.ojsPlusA.frontend.article.times##
- HTML (English) ##plugins.themes.ojsPlusA.frontend.article.downloaded##: 72 ##plugins.themes.ojsPlusA.frontend.article.times##
##plugins.themes.ojsPlusA.frontend.article.downloadstatastics##
##plugins.block.makeSubmission.linkLabel##
SJR
COPE
