abdominal pain

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abdominal pain by Mind Map: abdominal pain

1. Positive Key Features:

1.1. Pt presents to the clinic with stomach pain and difficulty keeping food down for 2 weeks. Pt stating that she first noticed the pain the morning after eating a bowl of homemade spaghetti the night before. PB states that it is a deep, dull, uncomfortable pain that comes and goes. PB rates the pain an 8/10 and states that it most often occurs shortly after meals and at bedtime. PB reports that nausea often accompanies the pain but has had no episodes of vomiting.

2. Possible Dx's:

2.1. I.

2.1.1. Gastro-esophageal reflux disease without esophagitis

2.1.1.1. burning sensation in your chest, usually after eating, which might be worse at night

2.1.1.1.1. #1 matches patient best!

2.2. II.

2.2.1. Acute peptic ulcer, site unspecified, without hemorrhage or perforation

2.2.1.1. most common peptic ulcer symptom is burning stomach pain

2.2.1.1.1. possibility d/t pt's description of symptoms.

2.3. III. Acute pancreatitis

2.3.1. abdominal pain that feels worse after eating

2.3.1.1. not likely but needs to be a differential.

2.4. IV. Ventral hernia without obstruction or gangrene

2.4.1. abdominal pain anywhere from just below the breastbone to the navel

2.4.1.1. not likely but will keep as a differential d/t symptoms

3. Vindicate

4. CV/Pulmonary:

4.1. Abdominal Aortic Aneurysm

4.2. Myocardial Infarction

4.3. Pneumonia

4.4. Pleural Restrictions

5. GI:

5.1. IBS

5.2. Crohn's Dz

5.3. Diverticulitis

5.4. GERD

5.5. PUD

6. Systemic:

6.1. Pancreatitis

6.2. Infection

6.3. Peritonitis

7. Urological

7.1. UTI

7.2. Urinary Obstruction

7.3. Kidney Stones

8. Negative Key Features:

8.1. PB reports that nausea often accompanies the pain but has had no episodes of vomiting. PB reports seeing a gastroenterologist in 2011 and had an esophageal dilation procedure. PB verbalized relief from the procedure for many years. PB was not placed on prescription antacid medication following the procedure 6 years ago.