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Pancreatitis: Pearls & Pitfalls

Pancreatitis seems straightforward in terms of evaluation, management, and disposition, but recent literature suggests we should make some changes. This post evaluates the ED evaluation and management of pancreatitis.

em@3am

EM@3AM: Esophageal Foreign Bodies

A 52-year-old male presents with inability to swallow. He was eating steak one hour ago and swallowed a large piece without chewing. He thinks it is stuck around his upper sternal area. Physical exam reveals a patient who appears uncomfortable, sitting upright, constantly spitting into a bag. You do not see anything in his mouth. What is the next step in your evaluation and treatment?

em@3am

EM@3AM: Toxic Megacolon

A 28-year-old male presents with abdominal pain, diarrhea, distension, and fever. He has a history of ulcerative colitis. Vital signs include BP 97/58, HR 121, T 100.9 Oral, RR 24, SpO2 98% on RA. Exam reveals a patient who appears systemically ill, and his abdomen is diffusely tender. His bowel sounds are decreased, but he has no peritoneal findings. KUB shows markedly dilated loops of bowel. What's the next step in your evaluation and treatment?

em@3am

EM@3AM: Small Bowel Obstruction

A 63-year-old female presents with abdominal pain, decreased bowel movements, nausea, three episodes of vomiting, and abdominal distension. She has a history multiple abdominal surgeries. Exam shows abdominal distension and generalized tenderness, but no peritoneal signs. What are your next steps?