Approach to periumbilical and lower abdominal pain Quiz: Ace Your Exams
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A 55-year-old man presents to the emergency department with worsening periumbilical abdominal pain for the past 24 hours. He describes the pain as crampy and intermittent, occurring every 15-20 minutes. The patient also reports nausea, vomiting, an inability to pass gas, and constipation. He has a history of an appendectomy 25 years ago. Temperature is 37°C (98.6°F), blood pressure is 128/76 mmHg, pulse is 112/min, respiratory rate 18 breaths/min, and oxygen saturation is 98% on room air. On examination, the abdomen is distended and tympanic to percussion with hyperactive bowel sounds. There is no rigidity or rebound tenderness. Which of the following is the most appropriate next step in evaluation?
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