Barbell Medicine Podcast Episode #340: Woman With Severe Abdominal Pain After Sit-Ups
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Mar 21, 2025 Dive into a perplexing medical mystery involving a young woman suffering severe abdominal pain after exercising. The discussion emphasizes the challenges of diagnosing abdominal issues in women, crucial factors like pain location, and the role of imaging in uncovering mysteries. Learn about rectus sheath hematomas and their risk factors, plus the typically harmless nature of these conditions. The episode wraps up with reassurance on exercise safety and an engaging call for listener interaction.
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Abdominal Pain Diagnosis
- Abdominal pain in young women has a broad differential diagnosis, requiring consideration of various organ systems and locations.
- Acute abdominal pain necessitates ruling out emergencies like vascular issues, obstructions, perforations, and ectopic pregnancies.
Refining the Diagnosis
- The patient's lack of nausea, vomiting, or changes in stool/urine makes GI or urologic issues less likely, but not impossible.
- Accutane use raises the possibility of pancreatitis, while the timing of her last period necessitates a pregnancy test.
Interpreting Vitals and Exam
- Reassuring vital signs give doctors time to investigate without immediate intervention.
- Normal bowel sounds and lack of rebound tenderness offer additional reassurance.