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29y/o
Male
Filipino
Married
Roman Catholic
Born on 21-Sept-1987, Itogon, Benguet
Abdominal Pain
HISTORY OF PRESENT ILLNESS
5 days PTA
Patient experienced sudden onset
abdominal pain, located in the
epigastric area, crampy, no aggravating
nor alleviating factors, nonradiating,
intermittent rated 5-6/10. With
associated loose bowel movement of 2-3
episodes. There were no nausea, no
vomiting, no loss of appetite, no fever.
No consult was made. No medications
were taken.
HISTORY OF PRESENT ILLNESS
Acute Gastroenteritis
with Moderate Signs of
Dehydration
ACUTE GASTROENTERITIS
Generally associated with other signs or
symptoms including nausea, vomiting, abdominal
pain and cramps, increase in intestinal gas-
related complaints, fever, passage of bloody stools
(dysentery), tenesmus (constant sensation of urge
to move bowels), and fecal urgency. (1)
(1) Guidelines on acute infectious diarrhea in adults. The Practice Parameters Committee of the American College of
Gastroenterology. American Journal of Gastroenterology. 1997 Nov;92(11):1962-75.
IMPRESSION
IMPRESSION
DIFFERENTIAL DIAGNOSIS
Bacterial Viral
Cause Nature of Location and Associated Precipitating
patient nature of pain Symptoms and aggravating
factors
(6) World Gastroenterology Organisation (WGO). WGO practice guideline: acute diarrhea. Munich, Germany: World
Gastroenterology Organisation (WGO); 2008 Mar.
DX:
CBC
UA
Stool Exam
TX:
PNSS 1L x 49gtt/min
Monitor Abdominal Status
PATIENT EDUCATION
Many diarrheal diseases can be prevented by
following simple rules of personal hygiene and
safe food preparation.
Hand-washing with soap is an effective step in
preventing spread of illness and should be
emphasized for caregivers of persons with
diarrheal illnesses.
As noted above, human feces must always be
considered potentially hazardous, whether or
not diarrhea or potential pathogens have been
identified. (3)
(3) Practice Guidelines for the Management of Infectious Diarrhea. Infectious diseases Society of America. Clinical Infectious Diseases 2001; 32:33150.
ACUTE GASTROENTERITIS
When to discharge?
Stable Vital signs
Maintains a sufficient fluid intake
Able to eat meals adequately
Able to take medications (if still indicated) (6)
(6) World Gastroenterology Organisation (WGO). WGO practice guideline: acute diarrhea. Munich, Germany: World
Gastroenterology Organisation (WGO); 2008 Mar.