[32F] Experiencing severe right-sided abdominal pain with weakness and hunger

Patient Description

A 32-year-old female presents with severe, sharp right-sided abdominal pain that began approximately an hour ago and has since migrated or radiated downward. The pain is described as intense, with a 6/10 severity, and has not been relieved by any measures. Accompanying the pain, the patient reports significant weakness, rating it 7/10 in severity, which started about 20 minutes after the onset of the abdominal pain. This weakness has impacted her mobility and energy levels, making it difficult to move from her car to her house. The patient also feels extremely hungry but is unable to eat due to the pain and potential nausea, although she has not vomited. She experienced a hot flash and lightheadedness at the onset of the pain. The patient has a history of ovarian cysts, with one ovary removed due to a large cyst, and major depressive disorder diagnosed 5-7 years ago. She is currently taking Ibuprofen and Tylenol for pain management as needed, and Zyrtec for recent allergy symptoms. There is a family history of emergency appendectomy and gallbladder removal in her mother. The patient has no known drug allergies and is not on any other medications. She has not experienced any recent injuries, and her last bowel movement was soft and brown without any notable abnormalities.

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Arora's Assessment

What might be happening

Based on the information provided, the most likely diagnoses include:

  • Appendicitis: This condition is characterized by inflammation of the appendix, a small organ attached to the large intestine. Symptoms typically start with pain near the belly button that moves to the lower right side of the abdomen. Other symptoms can include loss of appetite, nausea, vomiting, and fever.

    • Treatment usually involves surgical removal of the appendix (appendectomy). Antibiotics may also be administered to treat any infection.

  • Gallstones: These are hard deposits that can form in the gallbladder, a small organ under the liver. Pain from gallstones is usually felt in the upper right abdomen and can radiate to the right shoulder or back. Other symptoms can include nausea, vomiting, and fever.

    • Treatment can involve medication to dissolve the gallstones or surgery to remove the gallbladder.

  • Ovarian cyst: Given your history of ovarian cysts, it's possible that a new cyst could be causing your symptoms. Ovarian cysts can cause abdominal pain, bloating, and a feeling of fullness.

    • Treatment can involve monitoring the cyst, birth control pills to prevent new cysts, or surgery to remove the cyst.

What you can do

Given the severity of your symptoms, it's important to seek immediate medical attention. Please go to the nearest emergency department or call an ambulance if you can't get there yourself. In the meantime, avoid eating or drinking in case you need surgery.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • Increased intensity or frequency of pain
  • Fever or chills
  • Vomiting
  • Blood in your stool or urine

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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9 mo ago

People Also Ask

What are the common symptoms of appendicitis?

Common symptoms of appendicitis include pain that starts near the belly button and moves to the lower right side of the abdomen, loss of appetite, nausea, vomiting, and sometimes fever.

How are gallstones typically treated?

Gallstones are typically treated with medication to dissolve them or surgery to remove the gallbladder, known as a cholecystectomy.

What are the potential complications of an untreated ovarian cyst?

Potential complications of an untreated ovarian cyst include rupture, which can cause severe pain and internal bleeding, or torsion, which can cut off blood supply to the ovary.

When should someone seek immediate medical attention for abdominal pain?

Immediate medical attention for abdominal pain should be sought if the pain increases in intensity or frequency, is accompanied by fever or chills, vomiting, or if there is blood in the stool or urine.

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