Case No. 32

How would you rate this case?

Awful

Poor

Average

Good

Perfect

Flag/Report
Case No. 32

Instructions:

What is the issue?

Let us know in a brief paragraph or sentence why you are flagging this case. Here are some other issues we, at Medzcool, would like to know about:

  • Spam or misleading content
  • Violation of privacy
  • Unnescessary sexual content
  • Unnescessary violent content
  • Hateful or abusive content
  • Promotion of harmful acts

Report:

Flagged cases and users are reviewed withing 24 - 48 hours upon submission of a report. The report will be reviewed to determine whether the case and it's author (user) has violated Medzcool's Terms of Use and/or Community Guidelines. Accounts are penalized for violations to either the Terms of Use and/or Community Guidlines. Repeated violations can lead to account termination.

Thank you for your report, it will be reviewed within the next 24-48 hrs.
Chief Complaint:

Acute epigastric pain and nausea

Published: June 1, 2017
Case No. 32
Author: ppwei
CASE SCENARIO

A 45 year old male with a history of alcohol abuse presents to the emergency department with acute nausea and epigastric abdominal pain for the past 5 hours. He appears to be in significant distress and is clutching his abdomen. A stat chest x-ray is unremarkable and shows no evidence of free air under the diaphragm. The patient is given IV narcotics, antiemetics, and fluid, and an NG tube is placed with relief of his symptoms. Blood work is notable for an extremely elevated lipase.

QUESTION

After the patient is admitted, what is the best approach to restarting his diet?

Keep the patient NPO to provide complete bowel rest for and provide continuous suctioning through the NG tube for 48 hours, then slowly restart a diet
Keep the patient NPO to provide complete bowel rest and provide continuous suctioning through the NG tube until lipase levels normalize, then slowly restart a diet
Keep the patient NPO to provide complete bowel rest and provide continuous suctioning through the NG tube until a CT abdomen shows resolution of the acute process, then slowly restart a diet
Start TPN on the patient and transition to a clear liquid diet as tolerated
Begin a high- carbohydrate, low-fat diet as soon as the patient expresses a desire to start eating
Begin a regular diet as soon as the patient expresses a desire to start eating