Does anyone remember this?

Nurses General Nursing

Published

When I first joined allnurses, last September, there were threads where the OP would describe a patient's presentation, list symptoms, etc People who replied theorized on what the dx might be. It took me a while to activate my membership, and I've never seen one of those threads again.

Here's one that stumped us...

32 y/o female

S/S

Abdominal pain, starts just below ribs on both sides, similar to menstrual cramps but pain unrealted to cycle...

Pain starts after eating starchy foods like bread...

Pain radiates to back a little below the axillary level...

Vitals T-100.8 P-108 R-16 B/P-150/100...

CBC, Chem-20, Amylase, Lipase, UA all WNL...

Negative gall bladder ultrasound, HIDA scan WNL - EF "high side of normal"

Medical History - T&A @ age 13, lady partsl delivery @ age 20, C-section x2 @ age 22 and 27...

Family History - Father with diabetes, Mother with pancreatic pseudocysts, sister with Raynaud's

No allergies...

Meds - Lexapro 10 mg daily

No pain relief with GI cocktail, no relief with Morphine 10 mg, no relief with Demerol 50 mg, good pain relief with Toradol 15 mg IM...

Negative EGD

Negative colonoscopy

That's about all I can remember...patient was in ER several times and we never saw her after she was refered to a surgeon...

~~

did she ever have a c reactive protein drawn?

was it up?

and 1 more ?

did she get a cat c gastrographin?

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My guess is abdominal migraine-vs-pancreatic spasms.

wouldn't her lipase be up with the pancreatic spasms?

i don't like the temp, hr > 100, and ^ bp.

i need more clues!

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Specializes in Emergency & Trauma/Adult ICU.

I would LOVE to keep reading case presentations like these ...

To the mods: could this be considered for a new forum? Otherwise postings w/more than one case could get very confusing.

Here's hoping this can be made into a new forum ... :)

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Celiac Sprue?

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