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Thread: CC: "Bloating After Ingestion of Fatty Meal and Abdominal Pain for 4 hrs"

  1. #1

    Default CC: "Bloating After Ingestion of Fatty Meal and Abdominal Pain for 4 hrs"

    Mr G.G., 42 yrs of age, came to the emergency setting describing bloating after ingestion of fatty meal and abdominal pain for 4 hrs. He reported persisting pain of abdominal, along with nausea and vomiting, fever, waist and back discomfort. The physical examination revealed vital signs including T 38.4C, P 124 per minute, BP 90/60 mm Hg. All muscles of abdomen were of stiffness, with tenderness and rebound tenderness. The bowel sound disappeared. The puncture from right bottom abdomen resulted in light reddish fluid. Other PEs are normal. Laboratory tests revealed a WBC of 16.2 x 10E6/L, and a serum amylase of 6000 U/L.
    Clinical Pharmacy Specialist - Hematology

  2. #2

    Default Re: CC: "Bloating After Ingestion of Fatty Meal and Abdominal Pain for 4 hrs"

    Working list of data

    Pertinent positive data:

    1.Bloating after ingestion of fatty meal
    2.Abdominal pain for 4 hrs (persisting)
    3.Nausea
    4.Vomiting
    5.Fever
    6.Waist discomfort
    7.Back discomfort
    8.Vital sign of T 38.4C
    9.Vital sign of pulse 124 per min
    10.BP 90/60 mm Hg
    11.Stiffness of abdominal muscles
    12.Abdominal tenderness and rebound tenderness
    13.Bowel sound disappeared
    14.Puncture from right bottom abdomen cavity - light reddish fluid
    15.Blood WBC 16.2 x 10E6/L (~16.2 x 10E9/L)
    16.Serum amylase 6000 U/L

    Pertinent negative data:
    Null
    Clinical Pharmacy Specialist - Hematology

  3. #3

    Default Re: CC: "Bloating After Ingestion of Fatty Meal and Abdominal Pain for 4 hrs"

    Subjective data:

    1.Bloating after ingestion of fatty meal
    2.Abdominal pain for 4 hrs (persisting)
    3.Nausea
    4.Vomiting
    5.Fever
    6.Waist discomfort
    7.Back discomfort

    Objective data:

    8.Vital sign of T 38.4C
    9.Vital sign of pulse 124 per min
    10.BP 90/60 mm Hg
    11.Stiffness of abdominal muscles
    12.Abdominal tenderness and rebound tenderness
    13.Bowel sound disappeared
    14.Puncture from right bottom abdomen cavity - light reddish fluid
    15.Blood WBC 16.2 x 10E6/L (~16.2 x 10E9/L)
    16.Serum amylase 6000 U/L

    Group related data:

    Group 1: Stomach and Pancreas
    1.Bloating after ingestion of fatty meal
    2.Abdominal pain for 4 hrs (persisting)
    3.Nausea
    4.Vomiting
    5.Fever
    6.Waist discomfort
    7.Back discomfort
    8.T 38.4C
    15.WBC 16.2 x 10E9/L
    16.Serum amylase 6000 U/L

    Group 2: Circulatory System
    9.Pulse 124 per min
    10.BP 90/60 mm Hg

    Group 3: Whole abdominal cavity
    5.Fever
    8.T 38.4C
    11.Stiffness of abdominal muscles
    12.Abdominal tenderness and rebound tenderness
    14.Puncture from right bottom abdomen cavity - light reddish fluid
    15.WBC 16.2 x 10E9/L

    Group 4: GI mobility
    13.Bowel sound disappeared
    Last edited by CheneyHsiung; Wed 13th April '16 at 10:57pm.
    Clinical Pharmacy Specialist - Hematology

  4. #4

    Default Re: CC: "Bloating After Ingestion of Fatty Meal and Abdominal Pain for 4 hrs"

    Determine each problem:

    SIRS with hypotension
    Acute pancreatitis
    Acute peritonitis

    Assess Each Problem:

    Each problem is then assessed in terms of each of the following characteristics:

    • Acuity (acute or chronic)
    • Severity (mild, moderate, or severe)
    • Symptom level (symptomatic or asymptomatic)
    • Treatment status (treated or untreated)
    • Degree of control (controlled or uncontrolled)
    • Classification (staging of disease)

    SIRS with hypotension:
    Acuity: acute
    Severity: severe
    Symptom level: asymptomatic
    Treatment status: untreated
    Degree of control: uncontrolled
    Classification: (blank)

    Acute pancreatitis
    Acuity: acute
    Severity: (blank)
    Symptom level: apparent and multiple symptomatic
    Treatment status: untreated
    Degree of control: uncontrolled
    Classification: (blank)

    Acute peritonitis
    Acuity: acute
    Severity: (blank)
    Symptom level: apparent symptomatic
    Treatment status: untreated
    Degree of control: uncontrolled
    Classification: (blank)
    Last edited by CheneyHsiung; Wed 13th April '16 at 11:19pm.
    Clinical Pharmacy Specialist - Hematology

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