Case Study, answer the following questions: Please use at least 3 references to back up the answers and cited. References paper needs to be in APA format references no older than 5 years. Thank you.
- What is your list of appropriate differential diagnoses and why? (please use the differential diagnoses provided below and add the ICD-10 codes)
- peptic ulcer disease (PUD)
- pancreatitis, acute
- What is the final diagnosis and what assessment findings serve to support this? (Please use the below diagnosis)
- What are the specific auscultation palpation findings of the abdomen that are normal versus abnormal?
Mr. p, a 25-year-old male, presents following the acute onset of diffuse midabdominal pain. He denies a history of gastrointestinal disease, hepatic or renal disease, previous abdominal surgery, or recent trauma. He does not use NSAIDs, aspirin, alcohol, or tobacco products.
However, given that rebound tenderness suggests aggravation of the inflamed parietal peritoneum, you do have an important starting point. Your differential diagnosis should be broad enough to capture several processes that can present with signs of peritoneal inflammation in an otherwise healthy young male.
Mr. C lacks most of the common signs and symptoms of appendicitis:
- Fever (15-67% sensitivity; 85% specificity)
- Vomiting (49% sensitivity; 76% specificity)
- Pain migrating secondarily to the RLQ (54% sensitivity; 63% specificity)
- RLQ tenderness (88% sensitivity; 33% specificity)
- Guarding (46% sensitivity; 92% specificity)
- Rebound tenderness (61% sensitivity; 82% specificity)
THE ONLY STATEMENT STATED WAS ABDOMINAL PAIN RADIATING TO THE UMBILICUS OTHER THAN THAT HE COULD NOT SAID EXACTLY WHERE THE PAIN WAS.
Nevertheless, Mr. C abdominal CT scan (94% sensitivity; 94% specificity) is fairly conclusive for the diagnosis of acute appendicitis. Further, his history does not support the diagnosis of pancreatitis (no IV drug or alcohol use); peptic ulcer disease (no ASA or NSAID use); or, small bowel obstruction (no history of prior abdominal surgery, Crohn’s disease, or hernia).
Mr. C is admitted to the hospital and will be observed for any progression of his signs and/or symptoms. If indicated, he will proceed immediately to surgical intervention with appendectomy. He will receive IV antibiotics for the duration of his hospitalization, followed by a ten-day course of oral antibiotics as a postsurgical outpatient.