You are assessing a patient who has presented to the emergency department with an acute onset of abdominal pain. List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses. Support your answer with a minimum of two APRN peer-reviewed resources.

You are assessing a patient who has presented to the emergency department with an acute onset of abdominal pain. List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses. Support your answer with a minimum of two APRN peer-reviewed resources.

You are assessing a patient who has presented to the emergency department with an acute onset of abdominal pain. List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses. Support your answer with a minimum of two APRN peer-reviewed resources.

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Acute onset abdominal pain is one of the most common complains in the emergency department rooms(Pemmerl & Hüfner, 2020).The acute onset abdominal pain can be accompanied by other symptoms such as vomiting, nausea and even fever. Acute abdominal pain might be a result of an infection, obstruction, inflammation or vascular occlusion. Peritonitis is one of the differentials of acute abdominal pain that requires immediate surgical consultation. It is the inflammation of the peritoneal cavity and on physical examination, there will be fever, absent bowel sounds and diffuse abdominal tenderness with rigidity. Severely ill patients might have low blood pressure, weak pulses, prolonged capillary refilland tachycardia(Kumar et al., 2021).

            Acute appendicitis the inflammation of the vermiform appendix presents with generalized or periumbilical pain that finally localizes in the eft lower quadrant, fever, vomiting and nausea(Krzyzak & Mulrooney, 2020). On physical examination, palpation deep palpation of the left ilia fossa illicit pain the right iliac fossa (Rovsings sign). Pain at the Mc Burney’s point and a positive psoas sign where their pain on passive extension on the right thigh is also indicative of appendicitis.

 Intestinalobstruction (IO) is another differential that can warrant a surgical consult.IO is the inability of intestinal contents to flow forward. The most common causes of IO include intra-abdominaladhesions, malignancies and hernias. Patients with hernias not only present with acute abdominal pain but also present with nausea, vomiting, constipation and abdominal distention. On physical examination, the practitioner will find abdominal distension with tympany to percussion and high pitched bowel sounds(Jackson & Vigiola Cruz, 2018).

References

Jackson, P., & Vigiola Cruz, M. (2018). Intestinal Obstruction: Evaluation and Management. American Family Physician, 98(6), 362–367.

Krzyzak, M., & Mulrooney, S. M. (2020). Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. https://doi.org/10.7759/cureus.8562

Kumar, D., Garg, I., Sarwar, A. H., Kumar, L., Kumar, V., Ramrakhia, S., Naz, S., Jamil, A., Iqbal, Z. Q., & Kumar, B. (2021). Causes of Acute Peritonitis and Its Complication. Cureus. https://doi.org/10.7759/cureus.15301

Pemmerl, S., & Hüfner, A. (2020). Das akute Abdomen: Ätiologie und Klinik [The Acute Abdomen: Etiology and Clinical Presentation]. Deutsche medizinische Wochenschrift (1946), 145(21), 1535–1543. https://doi.org/10.1055/a-1007-4174

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