Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman

Weight Loss, Abdominal Pain, and Distension in a 74-Year-Old Woman

Urgent message: Not all GI complaints can be attributed to gastrointestinal pathology; symptoms of dyspepsia, vomiting, early satiety, weight loss, and abdominal pain may also be from a pelvic etiology. Fabrizia Faustinella, MD, PhD and L. Alexandre Frigini, MD INTRODUCTION Gastrointestinal complaints are common in ambulatory centers, urgent care, and in emergency departments. The symptoms of abdominal pain, nausea, and vomiting account for 12% to 15% of ED visits.1 Several non-GI intra-abdominal, endocrine, and pelvic …

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A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, …

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An Uncommon Clinical Presentation of Ovarian Torsion

An Uncommon Clinical Presentation of Ovarian Torsion

Urgent message: Abdominal pain is an extremely common complaint in the urgent care setting. The differential diagnosis of abdominal pain is often a challenge, however, because many symptoms and signs are nonspecific. Ovarian torsion usually presents with sudden onset of severe, unilateral lower abdominal pain, associated with nausea and vomiting; however, in a small percentage of cases, the clinical course is prolonged, as the torsion can be intermittent. While failure to consider ovarian torsion in …

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Intermittent Abdominal Pain and Vomiting in a Teenager: One More Urgent Cause to Consider

Intermittent Abdominal Pain and Vomiting in a Teenager: One More Urgent Cause to Consider

Urgent message: Superior mesenteric artery syndrome should be included in the differential diagnosis in children with abdominal pain and weight loss with rapid increase in linear growth. Ralph Mohty, MS3, and Michael Esmay, MD Introduction Abdominal pain is one of the most common complaints in childhood. A minor self-limited condition such as constipation or viral gastroenteritis is usually the cause, but more serious conditions need further evaluation and management.1 Chronic abdominal pain is a term …

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A Rare but Insidious Cause of Abdominal Pain

A Rare but Insidious Cause of Abdominal Pain

Urgent message: Recognizing the need for workup and referral in patients, even if their symptoms are relatively common, is crucial for optimal outcomes Introduction Abdominal symptoms can be attributed to a wide array of causes. When etiology is not immediately apparent, searching for signs and symptoms the patient may not have reported—or even be aware of—may be the first steps toward timely diagnosis and treatment. In this case, the abdominal symptoms were ultimately due to …

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Clavicular Pain in a 23-Year-Old

Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …

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Diverticulitis in the Urgent Care Setting

Diverticulitis in the Urgent Care Setting

Urgent message: Abdominal pain due to acute diverticulitis is commonlyseen in the urgent care setting. This is a clinical update on the management and treatment of acute diverticulitis. Abdominal pain commonly presents in the ambulatory setting, in anywhere from 1.5% to 8% of patients.1,2 With diverticulitis being a common diagnosis in the presence of abdominal pain, the clinical challenge in a nurgent care setting is determining uncomplicated from complicated diverticulitis. Diverticulosis French pathologist Jean Cruveilhier …

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Tis the Season for Norovirus Out West

Tis the Season for Norovirus Out West

As public health officials in California warn of a jump in reported cases of norovirus—also known as winter vomiting disease—across the state, a preholiday gathering in Seattle illustrates the speed with which the virus can wreak havoc in tightly packed events. The California Department of Public Health has confirmed 32 outbreaks that sickened hundreds between October and the end of 2015. Meanwhile, more than 200 people came down with symptoms of norovirus, which include abdominal …

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Abdominal Pain of Unusual Origin in a Teen

Abdominal Pain of Unusual Origin in a Teen

Urgent message: Always be mindful of the ‘zebra’ in a stampede of ‘horses’ in the differential diagnosis. ELISABETH L. SCHEUFELE, MD, MS, FAAP Case Presentation J.H. is a 19-year-old Hispanic male presenting with abdominal pain and shortness of breath for the last 4 days. He had visited the urgent care clinic about 2 days before with similar symptoms and was discharged with a diagnosis of muscle strain. J.H. returned with persistent symptoms and he indicates …

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