Ch. 5 – 38 y/o woman with abdominal pain

   CT OUT OF PROPORTION TO EXAMINATION
A 38 year old woman with abdominal pain

A 38 year old woman with abdominal pain

“Think worst first”. That is our mantra.

“Treat the patient, not the test”. That is also our mantra.

How do we reconcile the two – well, sometimes it’s not that easy! This woman had excellent follow up, returned as instructed, then seemingly reached ‘follow-up fatigue’ (OK, I made that up). She eventually did not follow the advice of the doctor and had a devastating outcome as a result.

The emergency provider sees patients at one moment in time, ramping the importance of follow up to the next level. Sometimes follow up can be as easy as see your doctor if not better in 3 days, sometimes you need to make a call and get a definite time…

The story behind the story

ED chart from final visit (where the diagnosis was made)

Complete hospital discharge summary

2 thoughts on “Ch. 5 – 38 y/o woman with abdominal pain

  1. The outpatient appointment with the vascular surgeon a week after the initial visit is interesting . Obviously this patient’s financial constraints are stopping them from getting the necessary bloodwork and EKG. However I’m wondering what blood work this surgeon would’ve ordered and how that would have honestly affected his decision-making at that time.

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