Question

Part One:

For the following medical diagnoses, please describe the manifestations the patient will most likely present with. Please include pain characteristics (location, descriptions, onset, etc.) and associated signs and symptoms (such as nausea, abdominal signs, jaundice, etc.). Be as thorough as you can. Ask yourself this: if I get assigned a patient with this diagnosis, what things would I expect to see, what things would I assess for?

1. Peritonitis

2. Pancreatitis

3. Cholecystitis

4. Diverticulitis

Part Two -

Now…look at the following case scenarios and determine which diagnosis is most likely to be applicable to the patient.  

1. A 32-year-old female presents to the emergency room with complaints of abdominal pain. She describes generalized pain that started yesterday and worsened overnight. She indicates that the pain is now located in the RLQ. Upon auscultation, bowel sounds are hypoactive. Guarding noted with palpation, reports tenderness in RLQ, positive McBurney sign. Low grade fever noted, nausea with 2 episodes of vomiting since onset of pain.

This patient most likely has:

Why did you make this conclusion:

2. A 72-year-old male presents to the emergency room with complaints of colicky abdominal pain in his abdomen. He reports episodes of vomiting that is green in color and states that he feels better after vomiting. Upon assessment, his abdomen is rounded, distended and tympanic. Bowel sounds are hyperactive in the upper quadrants and high pitched. He denies passing flatus. Last bowel movement was 3 days ago.  

This patient most likely has:

Why did you make this conclusion:

3. A male patient presents to the emergency room with complaints of abdominal pain. He states the pain is constant and burning and points to his midepigastric area. States it has been present for “about 1 week”. He denies vomiting but does state he has some nausea after meals. Abdomen is not tender to palpation, non-distended, patient reports passing flatus. He reports having taken corticosteroids for the past 2 weeks for an asthma exacerbation.  

This patient is most likely experiencing:

Why did you make this conclusion:

Answer 1

PERITONITIS :It is the inflammation of the peritoneum and the Patient with this condition will most likely present with :

• Abdominal tenderness
• Increased peristalsis movement.
• Diarrhea
• Nausea and vomiting.
• Oliguria.
• Anorexia.
• Bloating of abdomen.

PANCREATITIS : It is a condition in which the pancreas is inflamed and the Patient will complain of :

• Pain at the epigastric region.
• Tenderness in the abdomen.
• Nausea and vomiting.
• Tachycardia.
• Increased pain post meal.

CHOLECYSTITIS :It is when the gall bladder is inflamed and the Patient will complain of :

• Pain in the right upper hypochondriac region.
• Tenderness in the abdomen.
• Nausea and vomiting.
• Fever.
• Anorexia.
• Abdomen bloating.

DIVERTICULITIS : It is a condition in which the diverticula which is a small pouches are inflamed and the  Patient will have :

• Pain at the lower left iliac region.
• Fever.
• Nausea and vomiting.
• Tenderness on touch.
• Constipation.