Emergency Medicine Clinics of North America
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#1Amal Mattu (UMB: University of Maryland, Baltimore)H-Index: 22
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Although abdominal pain is a common chief complaint in the emergency department, only 1 in 6 patients with abdominal pain are diagnosed with a gastrointestinal (GI) emergency. These patients often undergo extensive testing as well as hospitalizations to rule out an acute GI emergency and there is evidence that not all patients benefit from such management. Several clinical decision rules (CDRs) have been developed for the diagnosis and management of patients with suspected acute appendicitis and...
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Abdominal pain represents 5% to 7% of all emergency department presentations. Many patients require imaging for diagnosis, and choosing the appropriate imaging modality is a crucial decision point. Modern medicine offers a fantastic array of options including abdominal radiograph, computed tomography, MRI, and ultrasonography, but the plethora of alternatives can be paralyzing. This article introduces the commonly available modalities, discusses the advantages and disadvantages, and presents cur...
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#1Neeraja Murali (UMB: University of Maryland, Baltimore)
#2Sahar Morkos El Hayek (WashU: Washington University in St. Louis)
Abdominal pain is a common reason for emergency department visits, with many patients not receiving a definitive diagnosis for their symptoms. Non-gastrointestinal causes need to be considered in the workup of abdominal pain. A high index of suspicion is needed in order to develop a broad differential, and a thorough history and physical examination is paramount. This article will discuss some of these diagnoses, including can't miss diagnoses, common non-abdominal causes, and rare etiologies of...
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#1Carmen C. Wolfe (VUMC: Vanderbilt University Medical Center)H-Index: 1
#2Nicole McCoin (Ochsner Medical Center)
Abdominal pain in an immunocompromised patient represents a common clinical scenario that may have uncommon causes. Evaluation relies first on identifying the immunocompromise, whether due to congenital immunodeficiencies, malignancy, hematopoietic stem cell transplant, solid organ transplant, or human immunodeficiency virus/acquired immunodeficiency syndrome. Based on this determination, the emergency physician may then build a focused differential of pathophysiologic possibilities. Careful eva...
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#1Elizabeth Leenellett (UC: University of Cincinnati)
#2Adam Rieves (WashU: Washington University in St. Louis)
Occult abdominal injuries are common and can be associated with increased risk of morbidity and mortality. Patients with a delayed presentation to care or who are multiply injured are at increased risk of this type of injury, and a high index of suspicion must be maintained. A careful combination of history, physical examination, laboratory, and imaging can be quite helpful in mitigating the risk of a missed occult abdominal injury.
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#1Brian K Parker (University of Texas at Austin)
#2Sara Manning (IU: Indiana University)
Postprocedural complications encompass a wide array of conditions that vary in acuity, symptoms, index procedure, and treatment. Continued advancements in diagnostic and therapeutic procedures have led to a significant shift of procedures to the ambulatory setting. This trend is of particular interest to the emergency physician, as patients who develop complications often present to an emergency department for evaluation and treatment. Here the authors examine a high-yield collection of procedur...
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There are a variety of gastrointestinal pathologies that may be emergently identified in the patient who chronically uses alcohol or other substances. Patients may present to an Emergency Department with abdominal complaints existing on a spectrum from vague and benign to systemically toxic and potentially life-threatening. This article highlights ethanol, opioids, and other common substances of abuse and how they may contribute to gastrointestinal complaints.
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The physical examination of the patient is the cornerstone of the practice of medicine, and the skills to complete a thorough abdominal examination are critical in the care of patients. When performed correctly, the abdominal examination can be revealing when it comes to the overall health of the patient as well as acute pathology. The examination of the abdomen has the potential to minimize further testing or radiation and serves as a key diagnostic tool. In this article, we will discuss each p...
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