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Left Upper Quadrant Abdominal Pain

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1. Shingles in Pregnancy: An Elusive Case of Left Upper Quadrant Abdominal Pain (PubMed)

Shingles in Pregnancy: An Elusive Case of Left Upper Quadrant Abdominal Pain Pregnancy can complicate the presentation and workup of abdominal pain. A healthy 21-year-old gravida-3 para-1 woman at 34 weeks of gestation presented for severe pain localized to her abdominal left upper quadrant (LUQ. Physical exam was unremarkable except for localized pain on palpation, and she was discharged with acetaminophen and cyclobenzaprine for presumed musculoskeletal pain. The next day, she returned (...) for worsening pain. An extensive workup including labs, electrocardiogram, chest x-ray, and abdominal computed tomography was unremarkable, and she was discharged with hydrocodone/acetaminophen. Later that evening, after two discharges, the patient presented for increased pain with new onset of vesicles in her left T6 dermatome. She was diagnosed with shingles, started on valacyclovir and gabapentin, and eventually went on to deliver a healthy infant. Shingles classically presents as excruciating pain

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2018 Hawai'i Journal of Medicine & Public Health

2. Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia (PubMed)

Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia This single-subject case report aims to describe and discuss a case of a patient with established C5 tetraplegia with acute coronary syndrome presenting with left upper quadrant pain and tenderness.A 65-year-old male with chronic C5 American Spinal Injury Association Impairment Scale (AIS) A tetraplegia presented to the emergency department with severe left upper quadrant pain (...) radiating across the chest to the right upper limb with associated dyspnoea and diaphoresis. Prior to his emergency department admission, he had experienced progressive worsening of left upper quadrant pain and tenderness over several months. He was a non-smoker and swam regularly. He underwent coronary angiography and was found to have significant coronary artery disease. Drug-eluting stents were placed to critical coronary artery lesions followed by an uneventful hospital course with complete symptom

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2017 Spinal cord series and cases

3. Left Upper Quadrant Abdominal Pain

Left Upper Quadrant Abdominal Pain Left Upper Quadrant Abdominal Pain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Left Upper (...) Quadrant Abdominal Pain Left Upper Quadrant Abdominal Pain Aka: Left Upper Quadrant Abdominal Pain , LUQ Abdominal Pain , LUQ Pain From Related Chapters II. Causes: Gastrointestinal III. Causes: Miscellaneous Splenic enlargement, , splenic infarction, aneurysm Renal pain IV. Causes: Cardiopulmonary Empyema V. Imaging: Preferred Non-contrast Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Left Upper Quadrant Abdominal Pain." Click

2018 FP Notebook

4. Left Upper-Quadrant Appendicitis in a Patient with Congenital Intestinal Malrotation and Polysplenia (PubMed)

Left Upper-Quadrant Appendicitis in a Patient with Congenital Intestinal Malrotation and Polysplenia BACKGROUND Appendicitis is the most common cause of abdominal pain requiring emergent surgical intervention. Although typically presenting as right lower-quadrant pain, in rare cases it may present as left upper-quadrant pain secondary to abnormal position due to intestinal malrotation. Since atypical presentations may result in diagnostic and management delay, increasing morbidity and mortality (...) , accurate and prompt diagnosis is important. Therefore, acute appendicitis should be considered in the differential diagnosis of left upper-quadrant abdominal pain. In this setting, medical imaging plays a key role in diagnosis. We report a case of a 13-year-old female with undiagnosed intestinal malrotation presenting with left-sided acute appendicitis. CASE REPORT A 13-year-old Hispanic female presented at the emergency room with anorexia and left upper-quadrant abdominal pain with involuntary

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2018 The American journal of case reports

5. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

Medical Center Harvard Medical School Boston, MA Daniel Dante Yeh, M.D. Massachusetts General Hospital Division of Trauma, Emergency Surgery and Surgical Critical Care Boston, MA vii Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis Structured Abstract Background. The reliable identification of patients with abdominal pain who need surgical intervention for acute appendicitis can improve clinical outcomes and reduce resource use. The test performance and impact on outcomes (...) 34. Other adverse events 113 Table 35. Reported surgical complications of diagnostic laparoscopy 116 Table 36. Assessment of the strength of evidence for test performance and modifiers of test performance 122 Table 37. Evidence gaps for the diagnosis of right lower quadrant abdominal pain and suspected acute appendicitis 127 Figures Figure A. Analytic framework ES-5 Figure B. Flow chart of included studies ES-10 Figure 1. Analytic framework 7 Figure 2. Flow chart of included studies 16 Figure 3

2016 Effective Health Care Program (AHRQ)

6. Acute Nonlocalized Abdominal Pain

of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org ACR Appropriateness Criteria ® 4 Acute Nonlocalized Abdominal Pain in patients with more localized signs or symptoms, including the ACR Appropriateness Criteria ® topic on “Right Upper Quadrant Pain” [9], the ACR (...) with or without fever. Cholescintigraphy may have a role if there is specific concern regarding gallbladder or other hepatobiliary disease. Refer to the ACR Appropriateness Criteria ® topic on “Right Upper Quadrant Pain” for further discussion [9]. Summary of Recommendations ? Variant 1: In the setting of nonlocalized abdominal pain and fever, CT of the abdomen and pelvis with IV contrast is usually appropriate to evaluate for abdominal abscesses and a broad range of additional pathologies. ? Variant 2

2018 American College of Radiology

7. Left Upper Quadrant Abdominal Pain (PubMed)

Left Upper Quadrant Abdominal Pain We present a case of acute appendicitis from mobile cecum presenting with left upper quadrant abdominal pain.

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2012 Western Journal of Emergency Medicine

8. Left Upper Quadrant Abdominal Pain

Left Upper Quadrant Abdominal Pain Left Upper Quadrant Abdominal Pain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Left Upper (...) Quadrant Abdominal Pain Left Upper Quadrant Abdominal Pain Aka: Left Upper Quadrant Abdominal Pain , LUQ Abdominal Pain , LUQ Pain From Related Chapters II. Causes: Gastrointestinal III. Causes: Miscellaneous Splenic enlargement, , splenic infarction, aneurysm Renal pain IV. Causes: Cardiopulmonary Empyema V. Imaging: Preferred Non-contrast Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Left Upper Quadrant Abdominal Pain." Click

2015 FP Notebook

9. Restrictive strategy versus usual care for cholecystectomy in patients with gallstones and abdominal pain (SECURE): a multicentre, randomised, parallel-arm, non-inferiority trial. (PubMed)

with stepwise selection with usual care to assess (in)efficient use of cholecystectomy.We did a multicentre, randomised, parallel-arm, non-inferiority study in 24 academic and non-academic hospitals in the Netherlands. We enrolled patients aged 18-95 years with abdominal pain and ultrasound-proven gallstones or sludge. Patients were randomly assigned (1:1) to either usual care in which selection for cholecystectomy was left to the discretion of the surgeon, or a restrictive strategy with stepwise selection (...) for cholecystectomy. For the restrictive strategy, cholecystectomy was advised for patients who fulfilled all five pre-specified criteria of the triage instrument: 1) severe pain attacks, 2) pain lasting 15-30 min or longer, 3) pain located in epigastrium or right upper quadrant, 4) pain radiating to the back, and 5) a positive pain response to simple analgesics. Randomisation was done with an online program, implemented into a web-based application using blocks of variable sizes, and stratified for centre

2019 Lancet

10. Acute Appendicitis Presenting as Unusual Left Upper Quadrant Pain (PubMed)

Acute Appendicitis Presenting as Unusual Left Upper Quadrant Pain Appendicitis is the most common abdominal disease that requires surgery in the emergency ward. It usually presents as right lower quadrant pain, but may rarely present as left upper quadrant (LUQ) pain due to congenital anatomical abnormalities of the intestine. We report a patient who complained of persistent LUQ abdominal pain and was finally diagnosed by computed tomography (CT) as congenital intestinal malrotation complicated (...) with acute appendicitis. It is important to include acute appendicitis in the differential diagnosis of patients who complain of LUQ abdominal pain. Abdominal CT can provide significant information that is useful in preoperative diagnosis and determination of proper treatment.

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2013 Iranian Journal of Radiology

11. A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and abdominal pain. (PubMed)

-old man with 3 months history of intermittent melena, accompanied by the episodes of abdominal pain in the left upper quadrant and generalized fatigue was admitted to our department. The investigations showed that the patient had a low hemoglobin level, i.e. 10.9 g/dL with hypochromic microcytic anemia pattern seen in complete blood count (MCV 70.2 fl, MCH 21.4 pg). Esophagogastroduodenoscopy and colonoscopy did not reveal any abnormalities. Magnetic resonance enterography revealed a large (2.5 (...) A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and abdominal pain. Ectopic pancreas is an infrequent submucosal tumor in the gastrointestinal tract defined as a pancreatic tissue lacking vascular or anatomic continuity with the main body of the pancreas. Ectopic pancreas in the ileum is a rare and often an incidental finding. We report a case of ectopic pancreas in the ileum causing obscure gastrointestinal bleeding and episodes of abdominal pain.59-year

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2019 BMC Gastroenterology

12. Delayed diagnosis of abdominal pain in patient with situs inversus totalis in emergency department: A case report. (PubMed)

Delayed diagnosis of abdominal pain in patient with situs inversus totalis in emergency department: A case report. Abdominal pain is one of the most common complaints for patients in emergency department. It's difficult to make an accurate diagnosis by emergency physician in time, especially in patients with situs inversus totalis.A patient with acute exacerbation of chronic left upper quadrant abdominal pain.DIAGNOSES:: cholangiolithiasis with situs inversus totalis.laparoscopic (...) cholecystectomy and laparoscopic exploration of common bile duct.The patient had an uneventful recovery.High suspicion and adequate evaluation are important for diagnosis in patients with abdominal pain and situs inversus totalis in emergency department, and physical examination, electrocardiogrphy and radiological investigations are necessary.

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2017 Medicine

13. A rare diagnosis of abdominal pain presentation in the emergency department: Idiopathic omental bleeding: A case report. (PubMed)

of left upper quadrant abdominal pain after eating breakfast. The only associated symptom was 3 episodes of vomiting up food. Physical examination revealed mild left upper quadrant abdominal tenderness without muscle guarding or rebounding pain. Blood examination showed leukocytosis with neutrophil predominance and C reactive protein elevation. The pain was persistent and relief was not obtained by medication.Computed tomography showed a large lobular-contour homogenous slightly hyperdense lesion (...) A rare diagnosis of abdominal pain presentation in the emergency department: Idiopathic omental bleeding: A case report. Idiopathic omental bleeding is a rare cause of acute abdomen, with only a few reported cases. It usually presents with abdominal pain and may be life-threatening. As it rarely occurs, it may not be considered initially during patient presentation.A 35-year-old male came to our emergency department with abdominal pain present for around 5 to 6 hours. The patient complained

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2017 Medicine

14. An uncommon cause of abdominal pain: Mesenteric cyst (PubMed)

An uncommon cause of abdominal pain: Mesenteric cyst Mesenteric cysts are benign cystic lesions. Here, we present the case of a patient with abdominal pain, which was diagnosed as mesenteric cyst. A 28-year-old male patient was admitted to the emergency department (ED) with abdominal pain and distention. Abdominal palpation revealed a smooth-surfaced mass palpable in the left upper quadrant. Ultrasonography depicted a hypoechoic heterogeneous mass-like structure with a size of 15 × 12 cm (...) at the site of the operation and no cystic lesion after procedure. He was discharged 1 week after the procedure. Mesenteric cysts are extremely rare benign lesions of the abdomen, and emergency physicians must consider this disease in the differential diagnosis of abdominal pain. The percutaneous drainage technique performed on our patient is a safe technique for the treatment of selected patients.

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2017 Interventional medicine & applied science

15. Coping with Common GI Symptoms in the Community: A Global Perspective on Heartburn, Constipation, Bloating, and Abdominal Pain/Discomfort

examination should be carried out, and one should consider pelvic ultrasound and/or referral to a gynecologist. Table 1 Pain location and differential diagnosis Pain location Indication of origin Possible diagnosis Epigastric, upper abdominal Esophageal, stomach, duodenal, gallbladder, pancreatic GERD, gastritis, duodenal or gastric ulcer, cholecystitis, pancreatitis Large bowel—lateralization: Left: descending/sigmoid colon Diverticulitis Lower abdominal Right: ascending colon/cecum, appendix Crohn’s (...) and description • A chronic, localized or diffuse unpleasant feeling or pain in the abdominal cavity. • Dyspepsia (or indigestion) is a chronic or recurrent pain in the upper abdomen, with a sensation of fullness and early satiety when eating. It may be accompanied by bloating, belching, nausea, or heartburn. It is frequently associated with GERD and may be the first symptom of peptic ulcer disease and occasionally of gastric cancer. 4.2 Epidemiological notes • Several studies have reported prevalences

2013 World Gastroenterology Organisation

16. Omental Infarction: An Unusual Cause of Left-Sided Abdominal Pain (PubMed)

Omental Infarction: An Unusual Cause of Left-Sided Abdominal Pain Left-sided omental infarction (OI) is rare in both the adult and pediatric patients. To our knowledge, only 2 pediatric cases of a left-sided OI have been reported in the literature. We report a case of an obese 13-year-old male who presented with a 6-day history of intermittent, colicky, left upper quadrant abdominal pain.

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2014 ACG case reports journal

17. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

of recommendation 2 (Weak) Quality of evidence C (Low) We suggest surveillance imaging at 12-month intervals for patients with an AAA of 4.0 to 4.9 cm in diameter. Level of recommendation 2 (Weak) Quality of evidence C (Low) We suggest surveillance imaging at 6-month intervals for patients with an AAA between 5.0 and 5.4 cm in diameter. Level of recommendation 2 (Weak) Quality of evidence C (Low) We recommend a CT scan to evaluate patients thought to have AAA presenting with recent-onset abdominal or back pain (...) , particularly in the presence of a pulsatile epigastric mass or significant risk factors for AAA. Level of recommendation 1 (Strong) Quality of evidence B (Moderate) The decision to treat We suggest referral to a vascular surgeon at the time of initial diagnosis of an aortic aneurysm. Level of recommendation Good Practice Statement Quality of evidence Ungraded We recommend repair for the patient who presents with an AAA and abdominal or back pain that is likely to be attributed to the aneurysm. Level

2018 Society for Vascular Surgery

18. Pulmonary Embolism Presenting as Abdominal Pain: An Atypical Presentation of a Common Diagnosis (PubMed)

-old male who presented to the emergency department with worsening right upper quadrant abdominal pain with fevers. Initial imaging was benign, although lab work showed worsening leukocytosis and bilirubin. Abdominal pathology seemed most likely, but the team kept PE on the differential. Further imaging revealed acute pulmonary embolus in the segmental branch of the right lower lobe extending distally into subsegmental branches. The patient was started on anticoagulation and improved drastically (...) Pulmonary Embolism Presenting as Abdominal Pain: An Atypical Presentation of a Common Diagnosis Pulmonary embolism (PE) is a frequent diagnosis made in the emergency department and can present in many different ways. Abdominal pain is an unusual presenting symptom for PE. It is essential to maintain a high degree of suspicion in these patients, as a delay in diagnosis can be devastating for the patient and confers a high risk of mortality if left untreated. Here, we report the case of a 53-year

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2016 Case Reports in Emergency Medicine

19. Abdominal Pain Evaluation

) Right lower quadrant tenderness (LR+8) ( on right hip passive extension) Rovsing Sign ( on palpation of LLQ) ( on internal rotation of flexed right hip) Left lower quadrant pain Sigmoid (85% of cases) Right upper quadrant and epigastric tenderness Do not test by rapid release See for other methods (e.g. cough, inspiration, expiration) Perforated viscus Peritonitis VI. Exam: Genitourinary Examine for Consider rectal exam in all patients with Pain on palpation Occult or frankly bloody stool Pelvic (...) suspected Upper Endoscopy Indicated if suspected Indications Abdominal free air : 60-80% for perforated viscus (free air under diaphragm) However, chest/abdominal xray adds little if undergoing without delay Increased sensitivity Left lateral decubitus XRay XRay after 500 ml air given via Abdominal XRay (KUB) Indications ( is usually preferred) or Large : 71-77% perforation (free air, see above) Consider obtaining after stone localization on CT for monitoring Indications : 91-94% and : 78

2018 FP Notebook

20. Abdominal Pain in Older Adults

patients Mortality is twice that of younger patients (20%) Other causes Abdominal causes or or Abdominal muscle wall injury Extra-abdominal referred causes Inferior wall IV. Labs count is often normal despite peritonitis Comprehensive metabolic panel s may show or pyuria in V. Imaging Upright (or left lateral decubitus xray) Evaluate for abdominal free air Frequently needed to exclude serious pathology (e.g. AAA, , , , biliary disease) VI. Diagnostics Especially indicated in upper VII. Prognosis (...) Abdominal Pain in Older Adults Abdominal Pain in Older Adults Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Abdominal Pain in Older

2018 FP Notebook

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