Acute Abdominal Pain with Gastrointestinal Symptoms in Young Adult

Case at a Glance

A 20-year-old female presented with severe abdominal pain, vomiting, and associated symptoms raising concern for acute appendicitis or other gastrointestinal pathology.

Patient's Story

The patient, a 20-year-old female (height 5'8", weight 200 lbs) with a history of recurrent urinary tract infections and tobacco use via vaping, presented with acute onset severe abdominal pain. She awoke at 7:00 AM with excruciating stomach pain and immediately experienced difficulty with bowel movement, followed by severe cramping pain requiring her to brace herself. She developed cold sweats and near-syncope during the episode, which lasted approximately 20 minutes. Concurrent vomiting occurred during the acute phase. The patient noted no fever despite feeling cold. She was able to return to sleep after the initial episode. A second, less severe episode occurred at 11:30 AM without vomiting. At presentation, she reported persistent mild abdominal discomfort. Her dietary intake the previous day included processed meats, potato, eggs, pancakes, and ramen noodles.

Initial Assessment

Patient presented with acute severe abdominal pain with associated gastrointestinal symptoms including vomiting and bowel difficulties. Vital signs revealed absence of fever despite reported chills and cold sweats. The severe nature of pain with near-syncope and the specific pattern of symptoms raised immediate concern for acute abdominal pathology, particularly appendicitis given the patient's age and presentation.

The Diagnostic Journey

Initial evaluation focused on ruling out acute appendicitis and other causes of severe abdominal pain. Clinical assessment noted the need for physical examination to determine pain location and characteristics. Laboratory workup and imaging studies were recommended given the severity of presentation and potential for serious pathology. Differential diagnosis included acute appendicitis, gallbladder disease, gastroenteritis, and food-related illness.

Final Diagnosis

Pending comprehensive evaluation including physical examination, laboratory studies, and imaging to definitively diagnose the cause of acute abdominal pain.

Treatment Plan

Immediate medical evaluation recommended given the severity of symptoms and concern for acute appendicitis or other serious abdominal pathology. Patient advised to seek emergency medical care for proper physical examination, laboratory testing, and imaging studies as clinically indicated.

Outcome and Follow-up

Patient advised to seek immediate medical attention. Follow-up pending completion of diagnostic workup and definitive diagnosis. Close monitoring required given the potential for serious underlying pathology.