Digestive System Case Study
DC comes to the emergency room complaining of acute abdominal pain. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. The pain is located in her right upper quadrant and is “boring” into her back. She says she feels “gassy” and bloated.
What are your differential diagnoses?
Include the pathological process involved with your diagnosis.
What tests would you order to confirm your diagnosis?
What treatments or interventions would be the first line of protocol for your diagnosis?
Expert Solution Preview
As a medical professor, it is important to design assignments that challenge medical college students to think critically and apply their knowledge to real-life scenarios. The following is a case study regarding the digestive system and its potential diagnoses, tests, and treatments.
1. The patient’s symptoms suggest several possible differential diagnoses, such as cholecystitis, peptic ulcer disease, or pancreatitis. Cholecystitis is inflammation of the gallbladder, which may occur due to gallstones or bacterial infection. Peptic ulcers are sores in the lining of the stomach or duodenum, often caused by Helicobacter pylori infection or use of non-steroidal anti-inflammatory drugs (NSAIDs). Pancreatitis is inflammation of the pancreas, which may be due to gallstones, alcoholism, or high levels of triglycerides in the blood.
2. For cholecystitis, an ultrasound or CT scan may confirm the diagnosis. Blood tests, such as liver function tests, may also show elevated levels of certain enzymes. For peptic ulcer disease, an endoscopy may be necessary to visualize the ulcers and take a biopsy for further testing. A stool antigen test or breath test may detect the presence of H. pylori. For pancreatitis, blood tests for amylase and lipase levels may be elevated, and an abdominal CT scan may show inflammation or damage to the pancreas.
3. For cholecystitis, a conservative approach would be to manage pain with analgesics and antibiotics for infection. Surgery to remove the gallbladder may be necessary if symptoms persist or recur. For peptic ulcer disease, treatment may involve acid-reducing medications, antibiotics for H. pylori infection, and avoidance of NSAIDs. For pancreatitis, hospitalization with pain management and intravenous fluids may be necessary, and addressing the underlying cause, such as avoiding alcohol or treating high triglycerides, is key to prevention of future episodes.
The digestive system case study allows medical college students to consider the variety of potential diagnoses, testing, and treatment options for a common patient presentation. Through these assignments, students can hone their skills in deductive reasoning, clinical decision making, and communication with patients and healthcare providers.