Guess what it is

cointosser13

cointosser13

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So yesterday my partner and I ran a call for a male in his 40's who was having abdominal pain. First impression of the guy was, stable. He looked healthy, other than a yellowish tint (Jaundice) on his chest and abdomen. Guy didn't appear in any distress. His words exactly "Hey guys, I started having this pain in my low belly yesterday, and not too long ago I felt a little dizzy". So we did the whole 9 yards, IV, monitor and so on.

Here are his vitals,

Sinus tach on the monitor - 144 bpm (12-lead, no ST elevation or ectopy)
SpO2- 97-100 %
Blood pressure - 150/90, repeat was 164/86
Blood sugar - 366
Skin - cool, dry, light colored
History - Hypertension

Patient was not complaining of chest pain or difficulty breathing. That surprised me with the pulse where it was. Anyway, I asked the patient, "In general, how are you feeling right now?" Patient said "fine, I'm just having some pain in my lower stomach, I feel like it's moving too". Stomach felt non-rigid. Patient stated that the last time he saw a doctor was about a year ago.

We drop the patient off to the ER and give report. We leave and 30 minutes later we get a call from the patient's ER doctor and said that our patient went into the OR. What do you guys think the patient had?
 
I know that this could be something random and weird, as far as odd cases go but
Maybe AAA dissecting
or, off the wall, organ rupture??
 
What stands out to make yall think lupus ?

Does anyone else think maybe something with the liver ?
 
An obstructing gallstone. It's emergent because you can get septic.
 
Lupus... for sure!:)

Sounds like a AAA without the typical "tearing" sensation, but you're leading on to something other than that.

Truth of the matter.... Good job, you transported him, allowing him to get the proper diagnostic tests, thus... another life saved. (Unless he might have driven himself).
 
TXmed said:
What stands out to make yall think lupus ?
Click to expand...
It's always lupus until proven otherwise... didn't you go to medic school? ;)

Mine was taught by a doctor.... I forget his name though. Gregory something....
 
Is it possible that the "jaundice" is not actually jaundice, but a sign of bleeding into some of the deeper tissues? I've read that the conjunctiva of the eyes are the first place you notice hyperbilirubinemia, and the OP didn't mention anything about yellow eyes - just chest and abdomen.
 
That is correct. I guess we are just taking it at face value that it really is jaundice
 
Gurby said:
Is it possible that the "jaundice" is not actually jaundice, but a sign of bleeding into some of the deeper tissues? I've read that the conjunctiva of the eyes are the first place you notice hyperbilirubinemia, and the OP didn't mention anything about yellow eyes - just chest and abdomen.
Click to expand...

You are wise.
 
"True, but where does lower abd pain fit with liver/galbladder issues?"

Maybe the patient didn't read the same medical textbook that we have read.
It's all speculation until we get the CT result.
Interesting to think how an MD in, say, 1960, would have formed a diagnosis with these signs/symptoms and without CT or ultrasound.
 
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