This is an important part of the evaluation, as it provides a context for their physical complaints and may give clues to the correct diagnosis. It is essential to have your patients describe the details of the accident in depth. Source: Chief Complaint and History of Present Illness Post-traumatic stress disorder, acute stress reaction Laceration, sprain, strain, fracture, dislocation, ligament injury Sprain, strain, fracture, disc injury, lumbar radiculopathy Laceration, sprain, strain, fracture, dislocation, rotator cuff injury Sprain, strain, whiplash, fracture, cervical radiculopathy, disc injury Scrape, bruise, laceration, fracture, temporomandibular joint injury, dental injuryĬoncussion, post-concussion syndrome, closed head or traumatic brain injury This article will summarize an urgent care approach to chief complaints in patients who present to the urgent care center after a motor vehicle accident. It is vital that we not be lulled into a false sense of security not should we rush to expensive, in-depth radiological work-ups. Thus, our patients tend to be victims of low-speed, low-impact accidents who have presumed their injuries to be minor, however, this may not always be the case. In the urgent care setting, most victims of MVAs present on their own, sometimes even several days after the accident. The diverse injuries may be temporary, debilitating, or life-threatening (Table 1). However, it is imperative to maintain vigilance for potentially serious and even life-threatening injuries that may not be apparent.Īccording to the National Center for Health Statistics, motor vehicle accidents (MVAs) accounted for nearly 5 million ED visits in 2006. If you are not able to have surgery or cannot have it right away, the doctor may put a tube in the gallbladder to drain the bile.Urgent message: Patients presenting to urgent care in the wake of a motor vehicle accident have self-selected their treatment setting. You may be given fluids and antibiotics through an I.V. The doctor may try to reduce swelling and irritation in the gallbladder before removing it. You may need surgery as soon as possible. In some cases, you may need a more extensive surgery. This is called a laparoscopic cholecystectomy. This surgery can often be done through small cuts (incisions) in the belly. The main way to treat this disease is surgery to remove the gallbladder. Treatment for cholecystitis will depend on your symptoms and your general health. It can also help find blockage in the tubes (bile ducts) that lead from the liver to the gallbladder and small intestine (duodenum). This is a nuclear scanning test that checks how well your gallbladder is working. You may also have other tests, such as a gallbladder scan. This test also allows doctors to check the size and shape of your gallbladder. Ultrasound may show gallstones, thickening of the gallbladder wall, extra fluid, and other signs of cholecystitis. You may have blood drawn and an ultrasound, a test that uses sound waves to create a picture of your gallbladder. Your doctor will carefully feel your right upper abdomen to look for tenderness. Your doctor will ask about your symptoms and do a physical exam. Their only symptom may be a tender area in the abdomen. Pain for more than 6 hours, particularly after meals.Pain that gets worse during a deep breath.The most common symptom of cholecystitis is pain in your upper right abdomen that can sometimes move around to your back or right shoulder blade. It occurs when the gallbladder remains swollen over time, causing the walls of the gallbladder to become thick and hard. Long-term (chronic) cholecystitis is another form of cholecystitis. Problems from another severe illness, such as heart disease, diabetes, or an impaired immune system, cause the swelling. Infection or trauma, such as an injury from a car accident, can also cause cholecystitis.Īcute acalculous cholecystitis, though rare, is most often seen in critically ill people in hospital intensive care units. This results in an irritated and swollen gallbladder. The gallstone blocks fluid from passing out of the gallbladder. What causes it?Ī gallstone stuck in the cystic duct, a tube that carries bile from the gallbladder, is most often the cause of sudden (acute) cholecystitis. If the flow of bile is blocked, it builds up inside the gallbladder, causing swelling, pain, and possible infection. Normally, fluid called bile passes out of the gallbladder on its way to the small intestine. Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting food.
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