Case Study 1 – Abdominal Pain

Case Study 1 – Abdominal Pain

HPI:  15 year old female comes to the clinic presenting with a chief complaint of abdominal pain.  The abdominal pain is generalized in location, and described as a dull pain, non-radiating.  She notes some acid reflex, and reports she has a history of gastritis.  She also notes decreased appetite recently.  Denies any nausea or vomiting, denies any recent bowel changes.

PMHx, PSHx, FHx: Non-contributory

Social Hx:  Denies current sexual activity, denies alcohol use or smoking.  LMP was 2 week ago.

Physical Exam:  Unremarkable except some generalized tenderness in the abdominal region, no rebound, no guarding.  Rectal/pelvic exam was deferred.

Brief Differential Dx:





-Irritable Bowel Syndrome

Lab Tests:  There are several parasitology tests that are available at the clinic, but we chose to do a simple microscopic examination (“Parasitologia Simple) as well as an cytologic examination of the fecal mucous (“Moco Fecal”).  The microscopic exam simply examines a portion of stool under the microscope to look for any eggs, cysts, or other evidence of parasites.  The fecal mucous test is a way to examine the cytology of stool, looking for any evidence of certain cells (e.g. neutrophils, eosinophils, etc.)  The fecal mucous test helps to determine if a gastrointestinal infection is of viral or bacterial origin.

At least at the Belen clinic, there is no availability of testing for GERD (e.g. H. pylori antibodies, breath test, etc.).  However, if we truly suspect gastritis/GERD and want to confirm the diagnosis, we can refer the patient to have an endoscopy.

Although we do have a urine pregnancy test available at the clinic, we did not order it, mainly based on the patient’s denial of sexual activity and recent menstruation.

Treatment Plan:  We chose to treat the patient for gastritis/GERD symptoms, and started her on omeprazole (proton pump inhibitor) and metoclopromide (antiemetic and gastroprokinetic).  Gastritis/GERD, which is common in the U.S., also appears to be common here as well.  However, pending her stool results, we would also start her on an antiparasitic, the one commonly used here is tinidazole.  The main side effect of tinidazole is that it can have a disulfiram-like reaction when drinking alcohol.

In many cases of abdominal pain here in Peru, especially abdominal pain in children, physicians will treat the patient with antiparasitics empirically, as it is such a common problem.  Particularly within the patient population at the Belen Clinic, giardiasis appears to be a common problem.

This entry was posted in Case Studies. Bookmark the permalink.

26 Responses to Case Study 1 – Abdominal Pain

  1. James Samrov says:

    Lower left abdominal pain is the most common area for abdominal pain. You will know how debilitating lower left abdominal pain can be – whether it is an acute episode or chronic condition. The effects of abdominal pain can be devastating not just for the person living with the problem, but also for their family, friends and carers. The simplest chores and activities from shopping to walking may become impossible. Constant physical pain can impact on an individual’s emotional well-being. People living with a chronic condition may become depressed, and in some cases driven to suicide to escape the pain!are totally unsuitable. They are too bulky, move out of position, compact and cause oreness..

    Have a look at the most interesting blog post on our very own internet page

  2. It is not my fігst time to pay a visijt this website, i am browsing this website dailly and obtain fastidious information from here
    all tthe time.

  3. Pretty! This was an extremely wonderful post. Thank you for providing this info.

  4. Pingback: Good Burger The Movie Soundtrack | Cures 4 Heartburn

  5. Pingback: Acid Burn Drink | Gerd & Acid Reflux

  6. Pingback: Acid Reflux Friendly Drinks | Stomach Acid Heartburn

  7. Pingback: Acid Burn Chest Pain Empty Stomach | Stomach Acid Heartburn

  8. Pingback: Acid Reflux Dry Throat Morning | Treat Stomach Acid

  9. Pingback: Bcaa Acid Reflux | My life with acid reflux

  10. Pingback: Bad Stomach Acid When Pregnant | Stomach Acid & Gerd

  11. Pingback: What Does Milk Of Magnesia Do | Cures For Heartburn

  12. Pingback: Severe Acid Burn | Stomach Acid Heartburn

  13. Pingback: Heartburn Reduction Calcium Questions | Cures For Heartburn

  14. Pingback: Does Abdomen Acid Trigger Gasoline | Gerd or Heartburn?

  15. Pingback: Gerd Dhaka | Stomach Acid & Gerd

  16. Pingback: Heartburn Relief Why Is Celery Good For You | Stomach Acid Heartburn

  17. Pingback: Pregnant Gerd Remedies | My life with acid reflux

  18. Pingback: Acid Burn Remedies Yahoo Answers | Stomach Acid & Gerd

  19. Pingback: Gerd Irritated Tongue | Treat Stomach Acid

  20. Pingback: Heartburn Turning Into Cancer | Stomach Acid & Gerd

  21. Pingback: Ermahacid Burn Olermperic Dervers | Treat Stomach Acid

  22. Pingback: La Acid Burn Indigestion | My life with acid reflux

  23. Pingback: Heartburn Treatment Mayo Clinic | Treat Stomach Acid

  24. Pingback: Stomach Acid In Airway | Treat Stomach Acid

  25. Pingback: Stomach Acid A Symptom Of Labor | Treat Stomach Acid

  26. Adelle says:

    I am Adelle hello its me

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s