Phys Clinical Cases · general-medicine
Undifferentiated Presentations Abdominal Pain — DCE Clinical Case
DCE long-case and short-case station for Undifferentiated Presentations Abdominal Pain.
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Undifferentiated Presentations Abdominal Pain — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Undifferentiated Presentations Abdominal Pain. [1]
Presenting complaint: Subacute or acute symptoms referable to Undifferentiated Presentations Abdominal Pain, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References6ShowHide
- [1]Yew KS, George MK, Allred HB Acute Abdominal Pain in Adults: Evaluation and Diagnosis Am Fam Physician, 2023.PMID 37327158
- [2]Cartwright SL, Knudson MP Evaluation of acute abdominal pain in adults Am Fam Physician, 2008.PMID 18441863
- [3]Sangiorgio G, Biondi A, Basile F et al. Acute abdominal pain in older adults: a clinical and diagnostic challenge Minerva Chir, 2020.PMID 32550726
- [4]Broder JS, Oliveira J E Silva L, Bellolio F, Freiermuth CE, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department 2 (GRACE-2): Low-risk, recurrent abdominal pain in the emergency department Acad Emerg Med, 2022.PMID 35543712
- [5]Carpenter CR, Griffey RT, Mills A, Doering M, et al. Repeat computed tomography in recurrent abdominal pain: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department Acad Emerg Med, 2022.PMID 34897917
- [6]Luria L, Nguyen J, Zhou J, Jaglal M, et al. Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review World J Gastroenterol, 2014.PMID 25206297