Question

A. Present a detailed clinical account of a 32-year-old woman with a 3-day history of abdominal pains and vomiting.

B. From your presentation above, list ten (10) differential diagnoses.

Answer 1

Answer A:

Vomiting often causes abdominal pain as stomach acids travel backward through the digestive tract, irritating tissues along the way. The physical act of vomiting also may cause abdominal muscles to become sore. A wide range of factors can trigger vomiting, ranging from an intestinal blockage to alcohol poisoning.Cyclic vomiting syndrome is a disorder that causes recurrent episodes of nausea, vomiting, and tiredness (lethargy). This condition is diagnosed most often in young children, but it can affect people of any age.The episodes of nausea, vomiting, and lethargy last anywhere from an hour to 10 days. An affected person may vomit several times per hour, potentially leading to a dangerous loss of fluids (dehydration).

Acute and severe abdominal pain, however, is almost always a symptom of intra-abdominal disease. It may be the sole indicator of the need for surgery and must be attended to swiftly: Gangrene and perforation of the gut can occur 4-6 hours from onset of symptoms in certain conditions . Abdominal pain is of particular concern in patients who are very young or very old and those who have HIV infection or are taking immunosuppressants (including corticosteroids).The term acute abdomen refers to abdominal symptoms and signs of such severity or concern that disorders requiring surgery should be considered.

Answer B:

The 10 differential diagnosis can be:

1) Gastritis:Any of a group of conditions in which the stomach mucosal cells are affected.symptoms may include nausea, heart burn, abdominal pain.

2)Stomach flu:An intestinal infection marked by diarrhoea, cramps, nausea, vomiting and fever, abdominal pain etc.

3) Chemotherapy: chemotherapy of GIT cancers or tumor. Symptoms may include abdominal pain, vomiting and nausea.

4)Bowel obstruction:A gastrointestinal condition in which digested material is prevented from passing normally through the bowel.symptoms may include abdominal pain, nausea, vomiting etc.

5) Appendicitis:A condition in which the appendix becomes inflamed and filled with pus, causing pain, vomiting etc.

6)Crohn disease:A chronic inflammatory bowel disease that affects the lining of the digestive tract.

7)Ulcerative colitis:A chronic, inflammatory bowel disease that causes inflammation in the digestive tract. Symptoms include abdominal pain, vomiting, stools etc.

8) Cholecystitis:Inflammation of the gallbladder, a small digestive organ beneath the liver. Symptoms may include vomiting, nausea, abdominal pain etc.

9) Pancreatitis:Symptoms include upper abdominal pain, nausea and vomiting.

10)Duodenal ulcer:The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves with eating. With a gastric ulcer, the pain may worsen with eating. The pain is often described as a burning or dull ache.Symptoms may include vomiting, nausea and abdominal pain etc.