More Tummy Pain

Cardiovascular System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"The elderly patient with an acute abdomen is a not uncommon presentation in emergency medicine; it is also one of the most concerning, as almost 50% of such patients eventually require hospital admission, and between 20% to 33%, immediate surgery.\n\nThe lady in this case is an excellent example of why increased vigilance is essential in this population.\n\nFirst and foremost, note that she has presented with generalized abdominal pain which was severe enough to make her seek medical attention within a short span of time. However, examination of her abdomen reveals only mild, diffuse tenderness, a much more muted finding than one would expect.\n\nThis should not be interpreted as being reassuring - examination findings in the elderly can be misleadingly benign, even in the presence of severe pathology.\n\nNote also the presence of a heart rate \u003E90 bpm, a respiratory rate \u003E20 cycles\/minute, a borderline temperature, and a neutrophil leukocytosis; this confirms the presence of systemic inflammat"}]}

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