Abdominal pain and breathing difficulties

Medical Case Details:

Hello doctors,

An 18 year old female patient came to me with hypotension, abdominal pain, and breathing difficulties. The symptoms were managed with fluids and painkillers. All her routine tests are all in the normal range. She does not have a mass in the abdomen and has no history of pain during menstruation. Her chest and abdomen x-rays are also normal. But, she is again complaining of abdominal pain. The patient does not have a fever, and test for typhoid is also negative. What can be the cause of this abdominal pain and breathing difficulty?

Discussions

Dr. Madhumati Varma
Diabetologist

Have taken menstration history?
Ecoabdmen for ectopic pregnancy?
Hypotension , how much? Look like some focus of sepsis. Send blood culture.
May stress anxiety? Psychology opening,

05.May, 05:57pm

Dr. Sandeep Singh
General Practitioner

Menstrual history normal.. Utp nd typhoid negative.. Bp was 60/40.. All blood test results in normal limits

05.May, 11:03pm

Dr. Madhumati Varma
Diabetologist

Is she acute onset, emergency, send hospital, may Addison disease, short of hormone cortisol, aldosterone, may try Inj hidrocortison. Mentain IV fluid ringer lactat.But needed though evaluation and admission in hospital.

05.May, 11:21pm

Dr. Arvind Guru
General Surgeon

How is your patient now ?

What is the pain history - site , onset duration periodicity relation to food
Any blood in stools /
Any urinary symptoms
LMP ?
Drug ingestion ? Trauma ?

Her Wt and height BMI
Is it possible the hypotension in your patient is because of a very large cuff ?

Respiratory finding ? if any

Have you got USG Abdomen done ?

06.May, 01:00pm

Dr. Prisha Rishi
Family Physician

Hello, what are results of USG abdomen if you have done the same?

19.May, 06:48pm

Mehwish Mursaleen
Psychologist Counselor

Hello Dr.Sandeep Singh,
If the test results and your clinical judgment doesn't find any medical condition, it is a strong indication towards psychosomatic complaints. If breathing difficulties are more like heavy breathing/palpitations/anxiety symptoms, it is a further clue towards psycho-somatic disorder. The patient can be referred to a clinical psychologist for her psychological treatment.

25.May, 05:29pm

Dr. Sukhdev Garg
Anesthesiologist

What was the spo2 level??? where wa the abdininal pain in which quadrant?? aggravating , relievibg symptoms?? was there any tenderness on examination?? chest on auscultation??

28.May, 10:46am

Dr. Srushti Bhat
General Practitioner

If all tests are normal and no underlying pathology found, ask the patient if the pain is having an impact on quality of life. If no, just reassure the patient. However, hypotension of 60/40 needs to be looked into. Breathing diff may be due to an anxiety disorder.

20.Oct, 06:04pm

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