Index Note: Page numbers of article titles are in boldface type. A Abdominal pain, abdominal considerations in, 183 184 antiemetics in, 182 auscultation in, 170 C-reactive protein in, 174 175 character of, 167 classical presentation in, 170 computed tomography in, 177 180 D dimer in, 175 diagnostic imaging modalities in, 176 182 differential diagnosis of, 166, 169, 170, 171 evidence-based medicine approach to, 165 190 extra-abdominal examination in, 173 guarding in, 172 in geriatric patient, 363 375 abnormalities in, 365 371 disposition in, 371 extra-abdominal causes of, 369 370 general approach to, 364 365 history-taking in, 364 imaging in, 364 in appendicitis, 368 in biliary tract disease, 366, 367 in constipation, 370 in diverticular disease, 367 368 in large-bowel obstruction, 365 366 in malignancy, 370 in pancreatitis, 366 367 in peptic ulcer disease, 367 in small-bowel obstruction, 365 pharmacology-related, 371 physical examination in, 364 treatment and disposition in, 365 in immunocompromised patients, 377 386 intestinal fatty acid binding protein in, 175 laboratory testing in, 173 176 lactate elevations and, 175 176 lipase/amylase/liver function tests in, 176 location of, 166 167 lower, 229 249 onset of, 166 outside factors and, 167, 168 Emerg Med Clin N Am 34 (2016) 425 433 http://dx.doi.org/10.1016/s0733-8627(16)30011-6 0733-8627/16/$ see front matter ª 2016 Elsevier Inc. All rights reserved. emed.theclinics.com
426 Index Abdominal (continued) pain medication in, 182 183 palpation in, 171 past history and, 167 168 pediatric, causes of, 342, 344 345, 357 constipation in, 345 diagnosis and workup in, 345 epidemiology of, 341 342 history-taking in, 342 imaging in, 344 management of, 345 physical examination in, 342, 343, 345 physical appearance and, 169, 170 physical examination in, 168 173 plain radiographs in, 177 179 presenting illness in, 165 168 procalcitonin in, 175 radiation in, 167 rebound tenderness in, 172 rectal examination in, 173, 174 right upper quadrant, evaluating patient with, 211 228 special examination techniques in, 172 173 therapeutic management and disposition in, 182 184 ultrasound in, 180 182 vital signs in, 169, 170 white blood cell count in, 174 Abdominal pain mimics, 409 423 cannot miss diagnoses of, 411 412 requiring urgent evaluation, 412 417 unusual conditions causing, 417 420 Adrenal crisis, as abdominal pain mimic, 416 Amanita intoxication, as abdominal pain mimic, 414 415 Amebic colitis, 380 Anal fissures, 255, 256 clinical features of, 255 management of, 256 pathology of, 255 Anastomatic stenosis, as complication of Roux-en-Y gastric bypass, 398 Angioedema, hereditary, as abdominal pain mimic, 414 Anorectal abscesses/cryptitis, clinical features of, 257 management of, 257 258 pathophysiology of, 256 257 Anorectal complaints, in emergency department, 251 270 Anorectal fistula, 258 Aortic aneurysm, abdominal, anatomy/pathophysiology of, 332 333 causes/risk factors for, 333 clinical findings in, 333 334 imaging studies in, 334, 335 rupture of, locations of, 333 treatment of, 335 Aortoenteric fistulas, clinical findings in, 336
Index 427 imaging studies in, 336 337 pathophysiology of, 336 treatment of, 337 Appendicitis, acute, 229 235, 243 antibiotics in, 235, 236 diagnosis of, 231 235 disparities in, 230 epidemiology of, 229 230 imaging in, 232 235 in special populations, 231 laboratory testing in, 232 mimics of, 231, 232 synptoms of, 230 231 treatment of, 235 diagnosis and workup in, 352 354 in geriatric patient, abdominal pain in, 368 management of, 354 pitfalls of, 354 B Band erosion, as complication of laparoscopic adjustable gastric banding, 401 Band slippage and gastric prolapse, as complication of laparoscopic adjustable gastric banding, 401 Bariatric surgery, incidence of, 396 399 inclusion criteria for, 388 389 procedures for, 389 393 mixed malabsortive/restrictive, 389 392 surgical complications of, 396 399 Bariatric surgery patient, acute abdominal pain in, 387 407 cholelithiasis in, 395 postoperative bleeding in, 395 396 small bowel obstruction in, 396 surgical site infection in, 395 with abdominal pain, in emergency department, 394 395 Biliary pancreatic diversion, without and with duodenal switch, 390 391 Biliary system, disorders of, 216 217 Biliary tract disease, in geriatric patient, abdominal pain in, 366, 367 Black widow spider envenomation, as abdominal pain mimic, 415 416 Bowel, large, obstruction of, in geriatric patient, abdominal pain in, 365 366 small, obstruction of, in bariatric surgery patient, 396 in geriatric patient, abdominal pain in, 365 C Celiac disease, diarrhea in, 305 Chemotherapy, neutropenia related to, 383 Children, abdominal pain in. See Abdominal pain, pediatric. Cholelithiasis, in bariatric surgery patient, 395 Clostridium difficile, 301 302 Compartment syndrome, abdominal, in immunocompromised patients, 383
428 Index Congestive heart failure, as abdominal pain mimic, 412 Coronary syndrome, acute, as abdominal pain mimic, 411 Crohn s disease, management of, 239 Cytomegalovirus, 379 D Diabetic ketoacidosis, as abdominal pain mimic, 411 412 Diarrhea, 293 308 acute, bacterial causes of, 298 300 children with, treatment of, 297 298 definition of, 294 infectious etiologies of, 298 302 persistent and chronic etiologies of, 302 305 symptoms and exposures in, 295 dehydration in, 296 297 diagnosis and management of, 294 298 diagnostic considerations in, 293 history and physical examination in, 295 in celiac disease, 305 in HIV and AIDS, 304 305 parasitic, 303 stool studies in, 295, 296 traveler s, 301 Diverticular disease, in geriatric patient, abdominal pain in, 367 368 Diverticulitis, 239 242, 243 antibiotics in, 241 diagnosis of, 240 241 epidemiology of, 239 240 management of, 241 242 signs and symptoms of, 240 Dumping syndrome, as complication of Roux-en-Y gastric bypass, 398 Duodenum, anatomy of, 213, 215 Dyspepsia, 192 193, 194 medical management options for, 193 E Enterocolitis, necrotizing, diagnosis and workup in, 351 management of, 351 352 pitfalls of, 352 neutropenic, 383 384 Epigastric pain, approach to patients with, 191 210 Epilepsy, abdominal, as cause of abdominal pain, 419 Esophageal emergency(ies), 195 200 Boerhaave syndrome, 198 199 caustic ingestions as, 198 eosinophilic esophagitis, 200 esophagitis, 199 food bolus impaction as, 195 200
Index 429 pediatric, 198 in special populations, 199 200 Esophagitis, 199 as complication of laparoscopic adjustable gastric banding, 400 Boerhaave syndrome, 198 199 eosinophilic, 200 G Gallbladder, anatomy of, 211 212, 214 disease of, 216 217 with stones, 221 Gastric leak, as complication of sleeve gastrectomy, 402 Gastric remnant dilatation, as complication of Roux-en-Y gastric bypass, 398 Gastric stenosis, as complication of sleeve gastrectomy, 402 Gastroesophageal dilatation, as complication of laparoscopic adjustable gastric banding, 401 Gastroesophageal reflux disease, as complication of sleeve gastrectomy, 402 403 Gastrointestinal bleeding, 309 325 age and, 315 angiography in, 319 antibiotics in, 318 anticoagulation reversal in, 317 balloon tamponade in, 318 blood urea nitrogen:creatinine ratio in, 315 colonoscopy in, 319 epidemiology of, 309 311 etilologies of, 310 history and physical examination in, 312 imaging in, 318 319 incidence of, 310, 311 laboratory studies in, 312 localization of bleed in, 313 nasogastric tube aspiration in, 315 nuclear scan in, 319 platelet transfusion in, 317 prediction scores in, 312 313 prognosis in, 311 proton pump inhibitor in, 317 red blood cell transfusion in, 316 risk stratification of, 311 313 somatostatin/octreotide in, 317 stool examination in, 315 tranexamine acid in, 318 treatment of, 315 318 upper, clinical decision rules for, 314 endoscopy in, 318 vasopressin in, 317 318 Gastrointestinal disorders, functional, 355 356 diagnosis and workup in, 357 358
430 Index Gastrointestinal tract, lower, anatomy of, 252 Gastroparesis, 281 286 causes of, 282 evaluation of, in emergency department, 283 pathophysiology of, 282 presentation and diagnosis of, 282 283 symptoms of, 281 treatment of, 283 286, 287 Geriatric patient, abdominal pain in. See Abdominal pain, in geriatric patient. Gonadal torsion, 355 358 diagnosis and workup in, 355 356 pitfalls of, 356 Graft-versus-host disease, in immunocompromised patients, 383 H Hematologic malignancies, as abdominal pain mimic, 416 417 Hemorrhoids, clinical features of, 253 internal and external, anatomy of, 253 management of, 253 255 pathophysiology of, 252 253 Henoch-Schönlein purpura, as cause of abdominal pain, 418 Hernia, internal, as complication of Roux-en-Y gastric bypass, 399 ventral incisional, as complication of Roux-en-Y gastric bypass, 399 Hiatal hernia, as complication of laparoscopic adjustable gastric banding, 400 401 Human immunodeficiency virus/aids, diagnostic considerations in, 378 379 opportunistic infections in, 379 I Immunocompromised patient(s), abdominal pain in, 377 386 classification of, 378 opportunistic infections in, 383 384 treatment regimen complications in, 380 381 Inflammatory bowel disease, 235 239 clinical presentation of, 236 237 emergency department treatment of, 238 239 epidemiology of, 236 intestinal manifestations of, 237 management of, 237 238 side effects of medications in, 239 Inguinal hernia, incarcerated, diagnosis and workup in, 354 355 management of, 355 pitfalls of, 355 Intestinal epithelium, 294 Intragastric dual-balloon, 393 Intussusception, diagnosis and workup in, 347 348 management of, 348 349 pitfalls of, 349
Index 431 L Laparoscopic adjustable gastric banding, 392 complications of, 400 402 Lemierres syndrome, as cause of abdominal pain, 418 419 Liver, anatomy of, 211, 212 disorders of, 214 216 functions of, 213, 215 Lyme disease, as cause of abdominal pain, 419 M Malrotation, diagnosis and workup in, 349 351 management of, 351 pitfalls of, 351 with or without midgut volvulus, 349 351 Mesenteric ischemia, 327 332 abdominal aorta anatomy and, 328 clinical findings in, 329 etiology of, 328 329, 332 imaging studies in, 330 331 laboratory studies in, 329 330 pathophysiology and, 328 treatment of, 331 332 Metoclopramide, in gastroparesis, 284 Migraine, abdominal, as cause of abdominal pain, 420 Mycobacterium avium complex, 379 O Obesity, conventional therapy in, 388 incidence of, 388 Organ, solid, transplant of, immunosuppression in, diagnostic considerations in, 381 infections and, 381 382 postoperative complications of, 382 383 Ovarian torsion, 355 356 P Pain, abdominal. See Abdominal pain. Pancreas, anatomy of, 212 213, 215 disorders of, 217 Pancreatitis, acute, 200 207 BISAP score and, 203 205 causes of, 201 complications of, 202 diagnosis of, 202, 203 management of, 206, 207 medications causing, 201 SOFA score and, 203, 204
432 Index Pancreatitis (continued) hemorrhagic, 206 in geriatric patient, abdominal pain in, 366 367 in immunocompromised patients, 382 necrotizing, 205 Peptic ulcer disease, in geriatric patient, abdominal pain in, 367 Peptic ulcer disease/gastritis, 192 195 complications of, 194 195 Pilonidal abscesses/cysts, clinical findings in, 259 management of, 259 pathophysiology of, 258 Pneumonia, community-acquired, as abdominal pain mimic, 413 Polyarteritis nodosa, as cause of abdominal pain, 418 Porphyria, acute intermittent, as cause of abdominal pain, 417 418 Port infection, as complication of laparoscopic adjustable gastric banding, 402 Proctalgia fugax, 260 Proctitis, causes of, 268 Pruritus ani, clinical findings in, 261 management of, 261, 262 pathophysiology of, 260 Pulmonary embolism, as abdominal pain mimic, 412 Pyloric stenosis, 345 347 diagnosis and workup in, 346 347 management of, 347 R Rectal cancer, clinical findings in, 267 management of, 268 Rectal prolapse, 262 263 Rectal sexually transmitted infections, 264 265, 266 267 Rectal trauma, clinical findings in, 263 264 management of, 264 pathophysiology of, 263 Rectum, foreign bodies in, 263 264 Right upper quadrant, abdominal pathology in, 218 anatomy of, 211 disorders of, differential diagnosis of, 213 214 management and treatment of, 223 225 medical management of, 224 225 surgical treatment of, 224 pain, computed tomography in, 222, 223 differentiation of, signs and symptoms for, 219 imaging in, 220, 222 223 laboratory testing in, 220 nonabdominal causes of, 218 219 physical examination in, 219 220 plain radiographs in, 220 221 ultrasound in, 221 222 Roux-en-Y gastric bypass, 389, 390 complications of, 396 399
Index 433 S Sexually transmitted infections, rectal, 264 265, 266 267 Sickle cell disease, as abdominal pain mimic, 413 414 Sleeve gastrectomy, 392, 393 complications of, 402 403 Small bowel obstruction, 273 277, 286 causes of, 273, 274, 275 evaluation of, in emergency department, 275, 276 pathophysiology of, 273 274 treatment of, 275 277 Stomach, neuromuscular activity in response to food, 283 Stomal obstruction, as complication of laparoscopic adjustable gastric banding, 401 402 Stool guaiac testing, indications for, 192 Systemic lupus erythematosus, as cause of abdominal pain, 418 T Testicular torsion, 356 Tuberculosis, abdominal, 380 as cause of abdominal pain, 419 U Ulcerative colitis, medical management of, 238 Ulcers, marginal or stomal, as complication of Roux-en-Y gastric bypass, 398 399 V Variceal bleeding, 319 Varicella zoster, as cause of abdominal pain, 419 Vascular catastrophes, abdominal, 327 339 Vomiting, cyclic, 277 281, 286 differential diagnosis of, 279 evaluation of, in emergency department, 280 pathophysiology of, 277 278 presentation and diagnosis of, 278 279 treatment of, 280 281 differential diagnosis of, 272 Vomiting patient, 271 291 approach to, 272 273