Approaching the Patient with... Abdominal Pain

Learn how to approach the patient presenting with undiagnosed abdominal pain.

Using a step by step, systematic approach, this video will teach you how to investigate and manage a patient presenting with undiagnosed abdominal pain as a junior doctor

[leighsirvent]

Don’t forget to check rare diseases like Mesenteric Artery Ligament Syndrome, SMAS or Nutcracker. I went undiagnosed for 12 years because no one thought to check. The long term undiagnosed caused many other issues. Please, please consider this!

[Whatdoyouthink.]

Excellent presentation. Thanks for putting my mind at ease about my abdominal pain. Not as serious as I thought. This Doc is really on top of his game.

[drSJV]

A brilliant lecture, very well explained! Thank you so much! 😊

[DR-nhoo]

After attending the same regional public hospital where I had been treated for an adhesion of my bowel to my fallopian tube with surgery enacted by one kind gynaecologist and an unknown gastric surgeon for five hours approximately 2 years prior. I attended calmly, described symptoms of increasing waves of strong pain, feeling nauseous, not being able to keep anything down, feeling the need to open my bowels but unable to, reminded them of my prior surgery, and admitting to having self administered opioid medication. The outcome was sepsis causing renal failure and PTSD.
I was left to wait without care for twelve hours until I was approached by the head nurse and two security guards and I was frog marched out onto the street. My father took me back to the A&E where we waited for five hours before I was taken to a ward to wait for another two days without care, and without the morphine I had been taking for more than 5 years for back pain.
After being found, by a kinder doctor, unconscious, unable to give consent, I was rushed to surgery, where i was resected to a degree and, as told to my father, left with some black bowel that they hoped would improve. This began my experience of teetering next to death, denied relief, illiostomy, dialysis, ten years vomiting several times a day until finally a transplant that worked well, but left me with chronic diarrhoea.
All this was covered up with lies that blamed my bad behaviour, including abusing and apparently assaulting medical staff to provide an excuse for their inability to assess me and failure to diagnose.
I have been allowed absolutely no benefit of doubt, the hospital staff have been allowed infallibility.
I now feel my lawyers are working against my interests as we seem to be heading to more criticism of my behaviour while no push back has been worn against the chaotic, preposterous medical records that transgress nearly all statutory requirements, and worse, but it has not been ‘proven’ despite blatant cut and paste fraud.
They are claiming that they took one CT scan but despite a Professor of Surgery claiming there were clear sign of several closed loop obstructions, which were obviously found to actually be there, the hospital lawyers disagree.

I know that people can think it economically advantageous to neglect to treat drug users, but this is an absolutely false economy that is likely to be underlying the loss of trust in institutions hailed as the pillars of our civilised society. It really depends what you call civilised I guess, but if this is actually acceptable, then put a sign on the Accident and Emergency that says, “Anyone with a History of Illicit Drug Use, Do Not Enter!”
So aside from the stigmatisation that caused my catastrophic injuries and PTSD, pathologising marginalised people for their logical reactive behaviour is part of the same systematic gaslighting that underlies problematic behaviours, and the refusal to consider that health professionals sometimes abuse patients is the same dangerous proclivity for denial that could lead to the death nell of democratic processes.

[BoobooGame]

Thank you so much that was really very helpful . I hope you continue explaining other medical topics .

[tariqhassan]

Just excellent....!!!
Please provide us with more approach videos.

[harman-kardon]

Very helpful. More on approach videos please.

Thank you.

[tashinga.munjanga]

Great video, very thorough and informative. Keep it up

[lanapoulliot]

Very interesting; mirrors exactly the abdominal pain exams I've had. May I as a patient express my frustration that no reason for my pain is ever found. I believe that my right ovary is problematic because the pain is extremely localized to that place. I've got no gallbladder anymore, it can't be appendix because none of the other symptoms are present.

[charmainethane]

I had 4 yrs of investigations, with visible & measurable inflammation. The abdominal pain came from A.S.I.A & huge inflammation reaction to the mesh that was implanted for hernia!
Once the mesh & metal clips were removed the pain vanished. Not one Dr picked that up, I actually requested the removal myself.

[zanyarqadirahmad]

intense explanation, thanks very much.

[mijiowhoka]

is it possible to have a transcript of this presentation? very good session.

[stephenieknot]

I've been having a issues since this last summer and it's getting worse ultrasound / scope and nothening I'm being blown off 😭

[carladuffy]

How about torn muscles etc. this was missed in e, r,

[carolynwestlake]

I’ve got stomach pain and have a telephone consultation due to Covid in a months time. Don’t know how useful it will be🙁

[zuneid]

I liked the video, my question is: shouldn't the auscultation preceede the palpation. In the vid this is changed.
The palpation alters the bowel sounds, thus auscultate 1st and then palpate

[derekamanwiththegivennamej]

From one who had a bad resection near the pearadiam i experience pain like no other pain when facing a blockage. I have had Dr's who really get it and others you would rather take to the wood shack. You sound like you could teach the most seasoned Dr a thing or two about abdominal problems and pain.

[Sportliveonline]

abdominal pain habit changed from diarriea to blockage

[donaldthompson]

What about ACNES -Abdominal wall pain syndrome

[Just_nthombi]

My lecturer always said never demonstrate by pointing on your self.