An 73-year-old woman calls EMS and complains of sudden worsening of three days lasting abdominal pain. Today she vomited and she feels faint. The pain's getting worse with irradiation into tower back. The patient is brought by the ambulance to the emergency room - here she is conscious, clammy, hypotensive, afebrile, with inserted venous catether of G18 diameter. The abdomen is distended, painful, with impaired peristalsis. What tests will you perform in the ED?
Blood test is a basic examination, which may help to the correct diagnosis. Although ECG is at the ED always done, here we have to use a different examination to find the origin of abdominal pain.
Blood test is a basic examination, which may help to the correct diagnosis. Abdominal X-Ray we would rather use in case of suspected ileus, clinical condiciton of the patient does not indicate it.
Blood test is a basic examination, which may help to the correct diagnosis. Abdominal ultrasound seems to be at this point the most beneficial imaging technique. RESULTS: A large hematoma in the right half of the abdominal cavity, free liquid in the subhepatic space.
Correct answerRESULT: Abdominal aortic aneurysm + aneurysmatic dilatation of lower thoracic aorta. (Remark: The location of rupture cannot be identificated because of haemorrhagic shock at the time of examination.)
Blood test is a basic examination, which may help to the correct diagnosis. Indication for CT examination is correct, but in the ED we must act as quickly as possible. That's why we prefer to use the fastest available method, which is abdominal ultrasound. According to the results and clinical condition of the patient we complete the examination with abdominal CT.