Diagnostic Tests Appropriate for this Case and the Results Use to Make a Diagnosis
The diagnostic tests judged appropriate for this specific instance would include a full investigation of the complete blood count (CBC), electrolyte and glucose levels, liver function tests (LFTs), amylase and lipase levels, lipoprotein electrophoresis, and omega-3 fatty acid assays. In addition to ultrasonography (US) and computed tomography (CT) scans, the patient may need Magnetic Resonance Imaging (MRI) scan.
CBC data is critical in analyzing the presence of anemia or infection, suggesting an intra-abdominal disease causing abdominal pain. The results of the electrolytes and glucose tests will be used to assess dehydration, suggesting the existence of intestinal blockage. This disease occurs when a complete or partial obstruction inside the intestinal system hampers the patient’s capacity to digest fluids. The results of the liver function tests, in combination with the lipoprotein electrophoresis and omega-3 fatty acid analysis, would be used to determine the existence of gallstones, which might lead to cholecystitis. The amylase and lipase test results are used to evaluate probable pancreatic pathologies, such as pancreatitis or pancreatic cancer. Finally, MRI imaging would be used to dive further into the possibility of any underlying disease condition and to clearly validate the diagnostic finding.
No, I would not accept the patient’s current diagnosis since they do not seem to have any risk factors for pancreatitis, a perforated ulcer, or an abdominal aortic aneurysm. The patient’s symptoms indicate an acute abdominal presentation and call for more research.
Intestinal obstruction, gastritis, and cholecystitis are the three probable diagnoses that might be used in this patient’s differential diagnosis. Acute abdominal discomfort in older adults is often brought on by intestinal blockage, which is typically brought on by adhesions from prior surgery, ingestion of foreign material, volvulus, hernias, and tumors (Smith & Nehring, 2018). Vomiting, stomach distention, and nausea are their hallmarks. In addition, the patient could only feel discomfort in one particular abdominal quadrant. Radiologic investigations may reveal air-fluid levels, which would corroborate the blockage.
The most common causes of gastritis are non-steroidal anti-inflammatory medicines, alcohol intake, smoking, infections, or immune-mediated processes. Gastritis is a disorder that results in inflammation of the stomach lining. Epigastric discomfort, nausea, and vomiting are often present (Information et al., 2018). Endoscopic findings that are confirmed by biopsy may indicate gastritis.
On the other hand, cholecystitis, a gallbladder inflammation, is often brought on by gallstones or strictures that block the cystic duct. It often affects the right upper quadrant of the abdomen and is followed by abdominal discomfort, nausea, and vomiting (Jones et al., 2019). Additionally, the patient may have a fever, chills, and jaundice. The preferred imaging study to confirm the diagnosis is ultrasound.
In conclusion, the patient’s stomach discomfort may be brought on by intra-abdominal pathology, which needs more testing. The patient has no linked risk factors for an abdominal aortic aneurysm, a perforated ulcer, or pancreatitis. Hence the current diagnosis should be disregarded. Intestinal obstruction, gastritis, and cholecystitis are three potential illnesses that may be considered in the differential diagnosis. Finding the precise source of this patient’s stomach discomfort will need clinical examination and research.
References
Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & USA, 20894. (2018). Gastritis: Overview. In www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK310265/
Jones, M. W., Genova, R., & O’Rourke, M. C. (2019). Acute Cholecystitis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459171/