The Clinical Problem Solvers Episode 411 – RLR – Abrupt Abdominal Pain
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Aug 4, 2025 Dive into the complexities of abrupt abdominal pain, including hilarious medical mix-ups and critical assessment strategies. Learn about Eisenmenger syndrome and its connection to congenital heart defects. Explore the urgent management techniques for severe abdominal cases, highlighting the importance of timely imaging and intervention. The podcast also tackles the rising incidence of colon cancer in younger patients and the intriguing connections between recurrent intussusception and cannabinoid hyperemesis syndrome, emphasizing thorough clinical reasoning.
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Presentation of Abrupt Abdominal Pain
- A previously healthy 32-year-old presented with abrupt severe abdominal pain without fever but was very ill.
- His physical exam showed diffuse tenderness centered at the umbilicus, no distension, raising concern.
Rapid Diagnosis for Abrupt Pain
- Abrupt abdominal pain demands rapid diagnosis focusing on obstruction, perforation, or vascular events.
- Prioritize urgent CT imaging and evaluate EKG and troponin to exclude critical causes like intestinal obstruction or ACS.
Intussusception as Bowel Obstruction
- Small bowel intussusception occurs when a segment of bowel telescopes into another.
- It can present as small bowel obstruction with a transition point seen on CT imaging.