Emergency Cases Northwest Group

078 Started 9 Years Ago

Situation

Patient with chronic abdominal pain had diverticulitis with perforation.

Background

A 45 year old female patient presented with pain all over her abdomen. It had all started 9 years ago though was worse now. She had a history of right sided renal cancer, awaiting treatment and was previously suspected of diverticulitis. Was mildly tender all over the abdomen. CRP was 40, higher than baseline. She was admitted to the medical team who did a CT scan the next day: acute diverticulitis with perforation of the sigmoid colon.

Assessment

This patient could have easily been discharged given the non-specific signs, test results and chronic pain. Even referring to the medical team rather than the surgical team suggested the admitting clinician wasn’t really sure what the problem was.

Recommendation

If the patient presents to the ED saying a chronic pain is worse than usual, before diagnosing a non-emergency consider:

If the pain is chronic, why is it worse now?

How can abnormal test results be accounted for?



PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group