Abdominal and Gastrointestinal Emergencies, An Issue of Emergency Medicine Clinics of North America

Name: Abdominal and Gastrointestinal Emergencies, An Issue of Emergency Medicine Clinics of North America
Brand: Elsevier
Price: 94.0 EUR
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Joseph P. Martinez Autumn C. Graham(Autor*in)

Elsevier (Verlag)

1. Auflage

Erschienen am 28. Juli 2016

100 Seiten

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978-0-323-44462-0 (ISBN)

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Front Cover
Abdominal and Gastrointestinal Emergencies
Copyright
Contributors
CONSULTING EDITOR
EDITORS
AUTHORS
Contents
Foreword: "Oh, My Aching Belly!"
Preface: Abdominal and Gastrointestinal Emergencies
Evidence-Based Medicine Approach to Abdominal Pain
Approach to Patients with Epigastric Pain
Evaluating the Patient with Right Upper Quadrant Abdominal Pain
Lower Abdominal Pain
Anorectal Complaints in the Emergency Department
The Vomiting Patient: Small Bowel Obstruction, Cyclic Vomiting, and Gastroparesis
Diarrhea: Initial Evaluation and Treatment in the Emergency Department
Gastrointestinal Bleeding
Abdominal Vascular Catastrophes
Pediatric Abdominal Pain: An Emergency Medicine Perspective
Abdominal Pain in the Geriatric Patient
Abdominal Pain in the Immunocompromised Patient-Human Immunodeficiency Virus, Transplant, Cancer
Acute Abdominal Pain in the Bariatric Surgery Patient
Abdominal Pain Mimics
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA
FORTHCOMING ISSUES
August 2016
November 2016
February 2017
RECENT ISSUES
February 2016
November 2015
August 2015
CME Accreditation Page
PROGRAM OBJECTIVE
LEARNING OBJECTIVES
ACCREDITATION
DISCLOSURE OF CONFLICTS OF INTEREST
UNAPPROVED/OFF-LABEL USE DISCLOSURE
TO ENROLL
METHOD OF PARTICIPATION
CME INQUIRIES/SPECIAL NEEDS
Foreword: "Oh, My Aching Belly!"
Preface: Abdominal and Gastrointestinal Emergencies
Evidence-Based Medicine Approach to Abdominal Pain
Key points
INTRODUCTION
HISTORY OF PRESENTING ILLNESS
Onset
Location
Character
Radiation
Palliative, Provoking, or Associated Factors
Past Medical, Surgical, and Social History
PHYSICAL EXAMINATION
General Appearance
Vital Signs
Approach to Unstable Patients with Abdominal Pain
Physical Examination Findings
Inspection
Auscultation
Palpation
Guarding
Rebound Tenderness and Alternative Techniques
Localized Tenderness
Special Examination Techniques to Help with Specific Diagnoses
Rectal Examination
Extra-abdominal Examination
LABORATORY TESTING IN ABDOMINAL PAIN
White Blood Cell Count
C-Reactive Protein
Procalcitonin
D Dimer
Intestinal Fatty Acid Binding Protein
Lactate
Lipase/Amylase/Liver Function Tests
DIAGNOSTIC IMAGING MODALITIES
Plain Radiographs
Computed Tomography Scan
Ultrasound
THERAPEUTIC MANAGEMENT AND DISPOSITION
Gastrointestinal Cocktail
Antiemetics
Use of Pain Medication with Abdominal Pain
Disposition
Serial abdominal examinations
REFERENCES
Approach to Patients with Epigastric Pain
Key points
INTRODUCTION
Peptic Ulcer Disease/Gastritis
Complications
Hemorrhage
Perforation
Obstruction
ESOPHAGEAL EMERGENCIES
Food Bolus (Foreign Body) Impaction
Pediatrics
Caustic Ingestions
Boerhaave Syndrome
Esophagitis
Special Populations
Eosinophilic Esophagitis
PANCREATITIS
Necrotizing Pancreatitis
Hemorrhagic Pancreatitis
Management of Acute Pancreatitis
Pearls
Pitfalls
REFERENCES
Evaluating the Patient with Right Upper Quadrant Abdominal Pain
Key points
DIFFERENTIAL DIAGNOSES OF RIGHT UPPER QUADRANT DISORDERS
Disorders of the Liver, Biliary System, Pancreas, and Small Intestine
Biliary Disorders
Pancreatic Disorders
Other Abdominal Pathology Presenting as Right Upper Quadrant Pain
Nonabdominal Causes of Right Upper Quadrant Pain
EVALUATION TOOLS IN THE WORKUP OF THE PATIENT WITH RIGHT UPPER QUADRANT PAIN
Physical Examination
Laboratory Testing
Imaging
Plain Radiographs
Ultrasonography
Computed Tomography
Other Imaging Modalities
MANAGEMENT AND TREATMENT OF RIGHT UPPER QUADRANT DISORDERS
Surgical Treatment for Right Upper Quadrant Disorders
Medical Management of Right Upper Quadrant Disorders
SUMMARY
REFERENCES
Lower Abdominal Pain
Key points
ACUTE APPENDICITIS
Epidemiology
Disparities
Symptoms
Classic appendicitis
Atypical appendicitis
Special populations
Mimics
Diagnosis
Laboratory testing
Imaging
Computed tomography
Ultrasonography
MRI
Imaging recommendations
Decision rules
Treatment
Surgical treatment
Antibiotic treatment
Antibiotic choice
INFLAMMATORY BOWEL DISEASE
Epidemiology
Clinical Presentation
Management
Emergency Department Treatment
DIVERTICULITIS
Epidemiology
Incidence and risk factors
Age
Gender
Diagnosis
Clinical evaluation
Computed tomography and other imaging modalities
Management
Antibiotics
Indications for admission
Indications for surgery
Discharge considerations: diet and exercise
SUMMARY
PEARLS AND PITFALLS
REFERENCES
Anorectal Complaints in the Emergency Department
Key points
INTRODUCTION
HEMORRHOIDS
Pathophysiology
Clinical Features
Management
ANAL FISSURES
Pathophysiology
Clinical Features
Management
ANORECTAL ABSCESSES/CRYPTITIS
Pathophysiology
Clinical Features
Management
ANORECTAL FISTULA
PILONIDAL ABSCESSES/CYSTS
Pathophysiology
Clinical Findings
Management
PROCTALGIA FUGAX
PRURITUS ANI
Pathophysiology
Clinical Findings
Management
PROLAPSE
Pathophysiology
Clinical Findings
Management
FOREIGN BODIES/TRAUMAS
Pathophysiology
Clinical Findings
Management
RECTAL SEXUALLY TRANSMITTED INFECTIONS
Pathophysiology
Clinical Findings/Management
PROCTITIS
Pathophysiology
Clinical Findings
Management
RECTAL CANCER
Clinical Findings
Management
SUMMARY
REFERENCES
The Vomiting Patient
Key points
APPROACH TO VOMITING PATIENTS
SMALL BOWEL OBSTRUCTION
Introduction
Pathophysiology
Presentation and Diagnosis
Evaluation in the Emergency Department
Treatment
Summary
CYCLIC VOMITING
Introduction
Pathophysiology
Presentation and Diagnosis
Emergency Department Evaluation
Treatment
Summary
GASTROPARESIS
Introduction
Pathophysiology
Presentation and Diagnosis
Emergency Department Evaluation
Treatment
Metoclopramide
Domperidone
Erythromycin
Antiemetic agents
Interventional therapy
Summary
SUMMARY: PEARLS AND PITFALLS
Small Bowel Obstruction
Cyclic Vomiting
Gastroparesis
REFERENCES
Diarrhea
Key points
INTRODUCTION
GENERAL DIAGNOSTICS AND MANAGEMENT
ACUTE INFECTIOUS ETIOLOGIES
Viral
Selected Bacterial Etiologies
Bacterial Traveler's Diarrhea
Clostridium difficile
PERSISTENT AND CHRONIC ETIOLOGIES
Parasitic
Human Immunodeficiency Virus, AIDS, and Diarrhea
Celiac Disease
REFERENCES
Gastrointestinal Bleeding
Key points
INTRODUCTION
EPIDEMIOLOGY
RISK STRATIFICATION OF GASTROINTESTINAL BLEEDING
Prognosis
Historical Features and Physical Examination Findings
Laboratory Studies
Prediction Scores
Summary
LOCALIZATION OF THE BLEED
Examination of Stool
Nasogastric Tube Aspiration
Blood Urea Nitrogen:Creatinine Ratio
Age
TREATMENT
Red Blood Cell Transfusion
Platelet Transfusion
Anticoagulation Reversal
Proton Pump Inhibitor
Somatostatin/Octreotide
Vasopressin
Antibiotics
Tranexamic Acid
Balloon Tamponade
IMAGING AND ENDOSCOPY
Upper Endoscopy
Colonoscopy
Angiography
Nuclear Scan
VARICEAL BLEEDING
PEARLS AND PITFALLS
REFERENCES
Abdominal Vascular Catastrophes
Key points
INTRODUCTION
MESENTERIC ISCHEMIA
Introduction
Anatomy
Pathophysiology
Etiology
Clinical Findings
Laboratory Studies
Imaging Studies
Treatment
Summary
ABDOMINAL AORTIC ANEURYSM
Introduction
Anatomy/Pathophysiology
Causes/Risk Factors
Clinical Findings
Imaging Studies
Treatment
Summary
AORTOENTERIC FISTULAS
Introduction
Pathophysiology
Clinical Findings
Imaging Studies
Treatment
Summary
REFERENCES
Pediatric Abdominal Pain
Key points
BACKGROUND
EPIDEMIOLOGY
HISTORY
PHYSICAL EXAMINATION
IMAGING
PEDIATRIC CAUSES OF ABDOMINAL PAIN
Diagnosis and Workup
Management
PYLORIC STENOSIS
Diagnosis and Workup
Management
INTUSSUSCEPTION
Diagnosis and Workup
Abdominal radiographs
Abdominal ultrasound
Abdominal computed tomography/MRI
Fluoroscopy enema
Management
MALROTATION WITH OR WITHOUT MIDGUT VOLVULUS
Diagnosis and Workup
Management
NECROTIZING ENTEROCOLITIS
Diagnosis and Workup
Management
APPENDICITIS
Diagnosis and Workup
Management
INCARCERATED INGUINAL HERNIA
Diagnosis and Workup
Management
GONADAL TORSION
Diagnosis and Workup
Ovarian torsion
Testicular torsion
Diagnosis and Workup
Management
SUMMARY
REFERENCES
Abdominal Pain in the Geriatric Patient
Key points
INTRODUCTION
GENERAL APPROACH
Limitations to History-Taking
Limitations to Physical Examination
Imaging
General Treatment and Disposition Considerations
SPECIFIC ABNORMALITIES
Small-Bowel Obstruction
Large-Bowel Obstruction
Biliary Tract Disease
Pancreatitis
Peptic Ulcer Disease
Diverticular Disease
Appendicitis
Extra-Abdominal Causes of Abdominal Pain
Constipation
Malignancy
Pharmacology
Disposition/Special Considerations
SUMMARY
REFERENCES
Abdominal Pain in the Immunocompromised Patient-Human Immunodeficiency Virus, Transplant, Cancer
Key points
INTRODUCTION
HUMAN IMMUNODEFICIENCY VIRUS/AIDS
Diagnostic Considerations
Opportunistic Infections
CYTOMEGALOVIRUS
MYCOBACTERIUM AVIUM COMPLEX
ABDOMINAL TUBERCULOSIS
AMEBIC COLITIS
OTHERS
Treatment Regimen Complications
Other Complications
SOLID ORGAN TRANSPLANT
Diagnostic Considerations
Infections
First month
Months 1 to 6
Months 6 to 12
Other Postoperative Complications
Pancreatitis
Graft-versus-host disease
Abdominal compartment syndrome
CHEMOTHERAPY/NEUTROPENIA
Diagnostic Considerations
Opportunistic Infections
Other Immunocompromised Patients
PEARLS AND PITFALLS
REFERENCES
Acute Abdominal Pain in the Bariatric Surgery Patient
Key points
INTRODUCTION
OBESITY
CONVENTIONAL THERAPY
BARIATRIC SURGERY ON THE RISE
INCLUSION CRITERIA FOR BARIATRIC SURGERY
BARIATRIC SURGERY PROCEDURES
MIXED MALABSORPTIVE/RESTRICTIVE PROCEDURES
Roux-en-Y Gastric Bypass
Biliary Pancreatic Diversion without and with Duodenal Switch
RESTRICTIVE PROCEDURES
Laparoscopic Adjustable Gastric Banding
Sleeve Gastrectomy
INTRAGASTRIC DUAL-BALLOON
APPROACH TO THE BARIATRIC PATIENT WITH ABDOMINAL PAIN IN THE EMERGENCY DEPARTMENT
Airway
Breathing
Circulation
Other General Considerations
NONEXCLUSIVE COMPLICATIONS
Surgical Site Infection
Cholelithiasis
Postoperative Bleeding
Small Bowel Obstruction
SURGICAL COMPLICATIONS BY PROCEDURE
ROUX-EN-Y GASTRIC BYPASS
Anastomotic or Staple Line Leak
Anastomotic Stenosis
Dumping Syndrome
Gastric Remnant Dilatation
Marginal or Stomal Ulcers
Internal Hernia
Ventral Incisional Hernia
BILIARY PANCREATIC DIVERSION WITHOUT AND WITH DUODENAL SWITCH
LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
Esophagitis
Hiatal Hernia
Gastroesophageal Dilatation
Band Erosion
Band Slippage and Gastric Prolapse
StomaL Obstruction
Port Infection
SLEEVE GASTRECTOMY
Gastric Leak
Gastric Stenosis
Gastroesophageal Reflux Disease
SUMMARY
REFERENCES
Abdominal Pain Mimics
Key points
CANNOT MISS DIAGNOSES
Acute Coronary Syndrome
Diabetic Ketoacidosis
Pulmonary Embolism
Congestive Heart Failure
CONDITIONS REQUIRING URGENT EVALUATION
Community-Acquired Pneumonia
Sickle Cell Disease
Hereditary Angioedema
Amanita Intoxication
Black Widow Spider Envenomation
Adrenal Crisis
Hematologic Malignancies
UNUSUAL CAUSES TO CONSIDER
Acute Intermittent Porphyria
Systemic Lupus Erythematosus
Henoch-Schönlein Purpura
Polyarteritis Nodosa
Lemierres Syndrome
Tuberculosis
Lyme Disease
Varicella Zoster
Abdominal Epilepsy
Abdominal Migraine
PEARLS AND PITFALLS
REFERENCES
The Opioid Epidemic in the United States
Key points
INTRODUCTION
EPIDEMIOLOGY
Opioid Prescription Epidemic
Morbidity and Economic Burden
Demographics: Who Is at Risk?
Which Prescription Opioids Are Most Common?
Limitations of Data
RECENT TRENDS
HEROIN EPIDEMIC
Demographics: Who Is at Risk?
Limitations of Data
OPIOID ANTAGONIST AGENTS
Take Home Naloxone
OPIOID ANTAGONISTS AND PUBLIC HEALTH LAWS: BARRIERS AND SOLUTIONS
Laws Encouraging Access to Naloxone by Limiting Liability
Laws to Promote Prescribing of Opioid Antagonists
Good Samaritan Laws: Providing Immunity to Bystanders Who Report Overdose
SAFE OPIOID PRESCRIBING PRACTICE IN THE EMERGENCY DEPARTMENT
SUMMARY
REFERENCES
Index

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