Clinical Case Database / Category: Case Based Discussion
Lower abdominal pain in women of child-bearing age
Publication details
Ashis Banerjee FRCS FCEM, Domike Isiodu MB BS, David Mbamalu FRCS FCEM
Foundation Years Journal, volume 2, issue 3, p.151 (123Doc Education, London, March 2008)
Abstract
A 29-year-old woman attends the emergency department with a 1-day history of cramping lower abdominal pain, associated with nausea. She has no associated urinary or bowel symptoms. On examination, she is anxious and in pain, with a visual analogue score of 6/10. Apart from a heart rate of 100 beats per minute, her vital signs are within normal limits. Her abdomen is soft, with tenderness in the right lower quadrant. On venous blood testing, her white cell count is 12,000/µL. A urine dipstick confirms pyuria (leucocytes 2 ), with negative nitrites. The urine pregnancy test is negative. How would you proceed to manage her?
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Authors
Ashis Banerjee FRCS FCEM (Corresponding author)
Consultant / Honorary Senior Lecturer in Emergency Medicine
Chase Farm Hospital
Enfield
Middlesex
EN2 8JL
Domike Isiodu MB BS
Fixed-term Training Grade Doctor
Chase Farm Hospital
David Mbamalu FRCS FCEM
Consultant
Chase Farm Hospital
References
1 Hospital Episode Statistics. Department of Health, London, 2003–4.
2. Irvin TT. Abdominal pain: a surgical audit of 1190 emergency admissions. Br J Surg, 1989. 76:1121–1125.
3. Rhea JT, Halpern EF, Ptak T, Lawrason JN, Sacknoff R, Novelline RA. The status of appendiceal CT in an urban medical center 5 years after its introduction: experience with 753 patients. AJR, 2005. 184:1802–1808.
4. Symonds EM, Symonds IM. Essential Obstetrics and Gynaecology , 3rd edition, p 41. Churchill Livingstone, Edinburgh, 1998.
5. Hager WD, Eschenbach DA, Spence MR, Sweet RL. Criteria for diagnosis and grading of salpingitis. Obstet Gynecol, 1983. 61:113–114.
6. Radiation P rotection-118. R eferral guidelines for imaging. European Commission, 2000.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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