Increasing abdominal pain-nausea and some vomiting

Reference no: EM133707234

Question

The patient is an 84-year-old female who was brought to the emergency department by her family upon the family physician's advice. The patient said she had increasing abdominal pain, nausea, and some vomiting. This condition started two to three days ago, and the patient could not eat due to nausea. Before this episode of illness, the patient had been reasonably well, receiving medications for HTN and hypothyroidism. The patient was admitted. Overnight the patient appeared to become more acutely ill and developed respiratory distress, and the rapid response team evaluated her and obtained her physician's order to transfer her to ICU. Soon after, the patient required intubation and mechanical ventilation for acute respiratory failure. The patient had signs and symptoms of septicemia and sepsis, possibly with an intra-abdominal source. Blood cultures grew E. coli. She was taken to the operating room, where she underwent an exploratory laparotomy. The surgeons found acute bowel ischemia and gangrene involving 100 percent of the small bowel and the right colon. This was an inoperable condition, and the laparotomy site was closed. The family was advised of the patient's very poor prognosis and offered hospice care, which they accepted. The mechanical ventilation was discontinued after.

Reference no: EM133707234

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