Abdominal pain including loin pain

FRCEM EXAM QuestionsCategory: March 2018Abdominal pain including loin pain
FRCEM Intermediate Staff asked 1 year ago

60-years-old male presented to ER with a history of constipation and mild pain abdomen for 3 days. Was seen by the gastro and took bowel preparation solution for colonoscopy and given I.V morphine 10 mg after which he developed a sudden increase in his abdominal pain. O/E Abdomen: tender and rigid HR: 110/min BP: 90/50 mm Hg Spo2: 92 %.
RR: 30 breath/m

A. What is an X-ray abnormality? (1mark)
B. Give (4) Ed management apart from analgesia for this patient? (1mark)
C. What is the cause of an increase in pain? (1mark)

1 Answers
FRCEM Intermediate Staff answered 1 year ago

A.

free gas under the diaphragm

B.

Large caliber IV access and Send blood for FBC, U&E, LFTs, Glucose, clotting- IV fluid resuscitation
IV analgesia +/- antiemetic
IV broad-spectrum antibiotics
Catheterise and monitor fluid balance
NBM
Urgent surgical referral

C.
Bowel perforation