Practice tips

• Special caution is required at the extremes of age when the symptoms and signs do not often reflect the seriousness of the underlying pathology.

• If an elderly patient presents with intense acute abdominal pain, inadequately relieved by strong parenteral injections, likely causes include mesenteric artery occlusion, acute pancreatitis and ruptured or dissecting aortic aneurysm.

• When an inflamed appendix ruptures, the abdominal pain improves for a significant period of time.

• A false sense of security can also occur with a perforated ulcer.

• Pus cells and red cells may be present in the urine with appendicitis when a pelvic appendix involves the bladder and a retrocaecal appendix involves the ureter.

• Consider diabetic ketoacidosis in a patient with abdominal pain, tenderness and rigidity and deep sighing respiration.

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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