More Than Just A Tackle

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More Than Just A Tackle - Page #1

Author: Irina Padua, MD Co Author #1: Sarah Vengal, MD Senior Editor: Yaowen (Eliot) Hu, MD, MBA Editor: Christopher Ledford, MD Patient Presentation: 16 year-old high school football player presented with left shoulder and left upper abdominal pain. History: He was evaluated for acute abdominal pain during a game. He was tackled from the left side and was hit in the left abdomen and arm. He did not hit his head or have loss of consciousness. He reported that he just got the wind knocked out of him and returned to play prior to full evaluation. During the next play, he experienced worsening abdominal pain with movement and deep breaths. He subsequently developed increasing left shoulder and left upper abdominal pain. Following the play, he took himself out of the game for full sideline evaluation. Review of systems was negative for fevers, chills, recent illness, dizziness, confusion, vomiting, change in vision, shortness of breath, chest pain, palpitations, joint swelling, arthralgia, or rash. But, the review of systems was positive for nausea, abdominal pain, and left shoulder pain. Physical Exam: Vital signs: BP 100/90, HR 80, RR 12, Pain 8/10 General: alert, oriented, appeared to be in moderate distress. Left shoulder: non-tender to palpation, full range of motion, 5/5 strength. Abdomen: positive bowel sounds, firm, involuntary guarding, tender to palpation diffusely with worsened pain in left upper quadrant and epigastric area, positive Kehr's sign. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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