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Surgery pp 21–28Cite as

Abdominal Pain, Nausea, and Vomiting

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Abstract

A 38-year-old woman presents to the emergency department with colicky abdominal pain, nausea, and vomiting for the past day. She has had at least ten episodes of green, bilious emesis without blood. She has had no passage of stool or flatus per rectum since yesterday morning and has not eaten in 24 hours due to the vomiting and abdominal pain. She denies a history of similar symptoms and has no other medical problems. Past surgical history is significant for a cesarean section 2 years ago. Her temperature is 37.8 °C, heart rate is 122/min, blood pressure is 124/78 mmHg, and respiratory rate is 14/min. Her mucous membranes are dry and her abdomen is distended, with a well-healed low transverse abdominal incision. Auscultation reveals high-pitched tinkling bowel sounds. She has mild tenderness throughout the abdomen, but there is no rebound, guarding, or rigidity. No masses or hernias are identified. Rectal examination reveals normal tone, no gross blood, no masses, and no stool in the rectal vault. Laboratory examination is significant for a white blood cell count of 8.2 × 103/μL (normal 4.1–10.9 × 103/μL), hemoglobin 17 g/dL (12.3–15.7 g/dL), hematocrit 51% (37–46%), sodium 141 mEq/L (135–145 mEq/L), potassium 2.9 mEq/L (3.5–5.0 mEq/L), chloride 93 mmol/L (98–106 mEq/L), bicarbonate 34 mEq/L (24–30 mEq/L), BUN 36 mg/dL (7–22 mg/dL), and creatinine 1.2 mg/dL (0.56–1.0 mg/dL). Urinalysis demonstrates aciduria. Abdominal x-ray is provided in Fig. 3.1.

Keywords

  • Small bowel obstruction
  • Large bowel obstruction
  • Flatus
  • Constipation
  • Obstipation
  • Loops of bowel
  • Air-fluid levels
  • Ogilvie
  • Closed loop obstruction
  • Hernia

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Fig. 3.1

Suggested Reading

  • Cheadle WG, Garr EE, Richardson JD. The importance of early diagnosis of small bowel obstruction. Am Surg. 1988;54:565.

    CAS  PubMed  Google Scholar 

  • Duron JJ, Hay JM, Msika S, Gaschard D, Domergue J, et al. Prevalence and mechanisms of small intestinal obstruction following laparoscopic abdominal surgery: a retrospective multicenter study. Arch Surg. 2000;135(2):208–12.

    CAS  CrossRef  Google Scholar 

  • Felder S, Margel D, Murrell Z, Fleshner P. Usefulness of bowel sound auscultation: a prospective evaluation. J Surg Educ. 2014;71(5):768–73.

    CrossRef  Google Scholar 

  • Kozol R. Mechanical bowel obstruction: a tale of 2 eras. Arch Surg. 2012;147:180.

    CrossRef  Google Scholar 

  • Markogiannakis H, Messaris E, Dardamanis D, et al. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007;13:432.

    CrossRef  Google Scholar 

  • Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000;87:1240.

    CAS  CrossRef  Google Scholar 

  • Taylor MR, Lalani N. Adult small bowel obstruction. Acad Emerg Med. 2013;20:528.

    CrossRef  Google Scholar 

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Correspondence to Jill Q. Klausner .

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Klausner, J.Q., Chen, D.C. (2020). Abdominal Pain, Nausea, and Vomiting. In: de Virgilio, C., Grigorian, A. (eds) Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05387-1_3

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  • DOI: https://doi.org/10.1007/978-3-030-05387-1_3

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