Discussion: List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses
Discussion: List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses
You are assessing a patient who has presented to the emergency department with an acute onset of abdominal pain. List three differential diagnoses that would lead to immediate surgical consultation and what assessment findings lead to diagnoses. Support your answer with a minimum of two APRN peer-reviewed resources.
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DQ Question
The differential diagnoses that would lead to immediate surgical consultation of a patient presenting to the ED with an acute onset of abdominal pain are appendicitis, pancreatitis, and Abdominal Aortic Aneurysm (AAA).
Appendicitis is an inflammation of the vermiform appendix and is the most common cause of RLQ pain. It typically starts with dull periumbilical pain that shifts with time to the right lower quadrant. The assessment findings that would lead to a diagnosis of appendicitis include cramping abdominal pain in the periumbilical area (Krzyzak & Mulrooney, 2020). The abdominal pain is accompanied by nausea, vomiting, and anorexia. Physical exam findings that would suggest appendicitis include fever, right lower quadrant tenderness, and rebound tenderness located at the McBurney point (Krzyzak & Mulrooney, 2020). Complete blood count (CBC) and C-reactive protein (CRP) are usually elevated. In addition, an abdominal ultrasound revealing an inflamed appendix would confirm the diagnosis of appendicitis.
Pancreatitis would be identified as a diagnosis if the patient presents with epigastric pain accompanied by anorexia, nausea, and vomiting. Besides, pancreatitis would be suspected if the patient presents with acute-onset, persistent upper abdominal pain that radiates to the back. Physical findings that would lead to the diagnosis include hypoactive bowel sounds, abdominal tenderness, and guarding (Al Neimat et al., 2022).
AAA is an abnormal focal dilation of the abdominal aorta. The rupture of an abdominal aortic aneurysm is life-threatening and usually requires immediate surgical consultation. AAA would be diagnosed if the patient presented with shock in addition to diffuse abdominal pain and distension. Abdominal pain worsens during an aneurysm rupture and is typically severe diffuse pain accompanied by abdominal distension and a patient ends up in shock (Sakalihasan et al., 2018).
References
Al Neimat, K. S. Y., Alserhany, A. K., Eid, M., Alanazi, A. A. A., Alanazi, N. E., Alanazi, M. A., … & Abdullah, D. (2022). Updates In Prevalence, Risk Factors, Management And Outcome Of Treatment Of Acute Pancreatitis. https://doi.org/10.51847/TYrK6XBCYe
Krzyzak, M., & Mulrooney, S. M. (2020). Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus, 12(6), e8562. https://doi.org/10.7759/cureus.8562
Sakalihasan, N., Michel, J. B., Katsargyris, A., Kuivaniemi, H., Defraigne, J. O., Nchimi, A., Powell, J. T., Yoshimura, K., & Hultgren, R. (2018). Abdominal aortic aneurysms. Nature reviews. Disease primers, 4(1), 34. https://doi.org/10.1038/s41572-018-0030-7