Emergency Department Management of Patients With Complications of Bariatric Surgery - $49.00
Publication Date: July 2019 (Volume 21, Number 7)
CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-A or 2-B CME credits. CME expires 07/01/2022.
You are in the middle of a busy shift, during which you have seen several patients with abdominal pain, vomiting, and diarrhea. Your next patient is a 54-year-old woman who also presents for abdominal pain. She is 2 weeks out from a Roux-en-Y gastric bypass procedure and reports that her pain is diffuse and severe. She is ill-appearing, with vital signs notable for tachycardia, hypotension, and a low-grade fever. Her abdomen is diffusely tender and peritonitic. You immediately initiate resuscitation with IV fluids and broad-spectrum antibiotics and obtain laboratory studies and cultures. You have limited experience with such patients, but you realize that she will require advanced imaging to determine the diagnosis. You wonder what diagnostic tests to order and what treatment, if any, you should start…
You are later called to the bedside of another patient who presents for nausea and vomiting. He is a 38-year-old man who is 2 weeks out from the placement of a laparoscopic adjustable gastric band. He reports that he had an acute onset of nausea and vomiting this evening. He is actively vomiting on presentation and complains of diffuse abdominal pain, but is hemodynamically stable. While attempting to contact his surgeon, you wonder what the best imaging modality is to make the diagnosis….