Emergency Medicine

24 year old presenting with diffuse abdominal pain

Amrit Misra on May 24, 2013

24 year old type I diabetic presents to the Emergency Department with diffuse abdominal pain associated with nausea and vomiting for the past 12 hours.  He notes that he recently had an upper respiratory infection that resolved a few days ago.  He denies any chest pain, shortness-of-breath, dysuria, diarrhea, hematochieza, or joint pain.

PMHx: Type 1 Diabetes, diagnosed at age 5

PSHx/FMHx: Noncontributory

Medications: Insulin

Social: Non-smoker.  Report heavy alcohol use (3-4 drinks/day) from ages 20-22, but denies any illicit drug use.

  • Temp  36 C
  • HR  120
  • BP  96/58
  • RR  30
  • O2  90% on Room Air

Physical Exam:

General: Uncomfortable appearing man, laying on bed, moaning in pain.

Cardiovascular: Tachycardic, regular rate, s1 and s2 audible.  No murmurs, rales, or gallops.

Respiratory: Clear bilaterally to auscultation, with no wheezes, rhonchi, or crackles.

Abdominal: Diffuse pain to palpation.  No rebound tenderness or guarding.

24 year old type I diabetic presents to the Emergency Department with diffuse abdominal pain associated with nausea and vomiting for the past 12 hours.  He notes that he recently had an upper respiratory infection that resolved a few days ago.  He denies any chest pain, shortness-of-breath, dysuria, diarrhea, hematochieza, or joint pain.

PMHx: Type 1 Diabetes, diagnosed at age 5

PSHx/FMHx: Noncontributory

Medications: Insulin

Social: Non-smoker.  Report heavy alcohol use (3-4 drinks/day) from ages 20-22, but denies any illicit drug use.

  • Temp  36 C
  • HR  120
  • BP  96/58
  • RR  30
  • O2  90% on Room Air

Physical Exam:

General: Uncomfortable appearing man, laying on bed, moaning in pain.

Cardiovascular: Tachycardic, regular rate, s1 and s2 audible.  No murmurs, rales, or gallops.

Respiratory: Clear bilaterally to auscultation, with no wheezes, rhonchi, or crackles.

Abdominal: Diffuse pain to palpation.  No rebound tenderness or guarding.

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