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By Joseph Ryan, MD; Caleb Busch, MD; and Alex Merkulov, MD
History
A 92-year-old woman with a past medical history significant for breast cancer status post-bilateral mastectomy, hypertension, and atrial fibrillation/ flutter status post-ablation and pacemaker placement presented with a three-day history of abdominal pain and cramping. She was seen by her primary care physician and underwent an abdominal X-ray, which raised the possibility of a bowel obstruction. The patient was referred to the emergency department, where she presented with lower suprapubic cramping and pressure. She also reported feeling bloated with her last bowel movement occurring three days prior. She denied nausea, vomiting, fever, and chills. She had no recent colonoscopy or history of abdominal surgery. On physical exam, her abdomen was softly distended and nontender to palpation with hyperactive bowel sounds. Continue reading »
History
A 92-year-old woman with a past medical history significant for breast cancer status post-bilateral mastectomy, hypertension, and atrial fibrillation/ flutter status post-ablation and pacemaker placement presented with a three-day history of abdominal pain and cramping. She was seen by her primary care physician and underwent an abdominal X-ray, which raised the possibility of a bowel obstruction. The patient was referred to the emergency department, where she presented with lower suprapubic cramping and pressure. She also reported feeling bloated with her last bowel movement occurring three days prior. She denied nausea, vomiting, fever, and chills. She had no recent colonoscopy or history of abdominal surgery. On physical exam, her abdomen was softly distended and nontender to palpation with hyperactive bowel sounds. Continue reading »
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