Rounded abdomen on examination

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Reference no: EM133885180

Question

Willow is a 54-year-old female hospitalized for CHF exacerbation. You see her on hospital day #6 and find that she feels very "bloated." She reports that she has had several "loose stools" over the past 12 hours. Willow and her family note that she has not had a solid bowel movement since she was admitted to the hospital, or "at least five days."

Willow is found to have a firm, rounded abdomen on examination. Her abdomen is tender to palpation, and she continues to feel like she needs to pass gas. She ate a small breakfast this morning and denies nausea or vomiting but notes her appetite is not "as good as it is at home."

The nurses have attempted to give bisacodyl enemas but note that the patient has only had loose stools that they are aware of.

Willow's medication list includes:

Furosemide 40 mg, oral, daily, for heart failure, reduced ejection fraction (HFrEF)

Metoprolol 25 mg, oral, daily, for coronary artery disease (CAD)

Simvastatin 40 mg, oral, nightly, for hyperlipidemia (HLD)

Acetaminophen 1000 mg, oral, every 8 hours, as needed for pain.

Cetirizine 10 mg, oral, every 12 hours, for environmental allergies.

Senna-Docusate 8.6-50 mg, oral, every 12 hours, for constipation/GI prophylaxis.

Polyethylene Glycol 40 gm, oral, every 12 hours, for constipation/GI prophylaxis.

1. Which radiographic diagnostic do you think is the most appropriate as a first-line diagnostic for this patient and why?

2. Compare and contrast the use of an x-ray with computed tomography (CT).

Reference no: EM133885180

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