Flying Knees And Varices: Complications Of Abdominal Trauma In An Mma Fighter

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Flying Knees And Varices: Complications Of Abdominal Trauma In An Mma Fighter - Page #1

Author: James Mattson, MD Co Author #1: Dr. Amie Kim Senior Editor: Jessalynn Adam, MD Patient Presentation: 31 year old male presenting with shortness of breath, dizziness, and palpitations History: He flew back from Hawaii to NYC 2 weeks ago and noticed progressively worsening symptoms after his return. In Hawaii he was working as a stuntman, performing several MMA events. He denies any known injuries. His most debilitating symptom is decreased exercise tolerance with walking due to dyspnea. He can now only walk half a block at a time. He endorses left sided abdominal and epigastric pain, just below costal margin, characterized as dull ache with sharp pleuritic component. Of note, was admitted to the hospital 4 months prior for hematemesis. His Esophagogastroduodenoscopy showed gastric ulcers. PMH is also significant for seizures controlled with vimpat. Social history is remarkable for former daily alcohol abuse, but in the past 5 years drinks 2-5 drinks per week. He denies drug use for the past 5 years and does not smoke. Physical Exam: Vitals: Temp 98.5, HR 115, BP 119/79, RR 18, SpO2 98% General Exam: NAD Head Exam: NCAT Eye Exam: PERRLA EOMI Oral Exam: MMM no lesions Respiratory Exam: CTAB no c/r/r Cardiac Exam: sinus tach +s1, s2 no m/r/g Abdominal Exam: tender to palpation along L side of rib cage and abdomen, (+) L sided back pain in lumbothoracic area, minimally ttp along epigastric area, +normoactive bowel sounds, ND Extremities Exam: wwp, no edema Neurological Exam: aaox3, no focal deficits Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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