Gastrointestinal Case Study

Patient is a 68-year-old female with a past medical history of hypertension, hypothyroidism, and diabetes mellitus II who presents to the Emergency Department with a 2-day history of “achy” left lower quadrant abdominal pain, 9/10 on pain scale, low-grade fever, and nausea that started about 12 hours ago.

Her last colonoscopy was 2 years ago, findings were normal.

Physical examination: T 101.6°F. Bowel sounds are hypo-active. There is generalized tenderness with guarding in the left lower quadrant. Her stool is negative for occult blood. KUB shows distended loops of bowel + gas patterns, and a moderate rectal fecal mass, but no evidence of free air. She is started on intravenous fluids and a BM protocol with minimal improvement in her symptoms.

Discuss the following:

1. Give 3-5 Differential Diagnoses for this patient

2. What further testing would you perform to obtain your “working” diagnosis?

3. What is your final “working” diagnosis with a complete Management plan

4.What alternative or complementary techniques may benefit this patient both in acute care and for future prevention?