SDN members see fewer ads and full resolution images. Join our non-profit community!

Classic Symptom of Ischemic Colitis

Discussion in 'Step I' started by MudPhud20XX, May 18, 2014.

  1. MudPhud20XX

    MudPhud20XX 2+ Year Member

    Nov 25, 2013
    FA says it's "pain out of proportion to exam." Can anyone explain what this means? Also, what is the significance of this symptom?
    Thank you.
  2. SDN Members don't see this ad. About the ads.
  3. bulldogmed

    bulldogmed 2+ Year Member

    Mar 7, 2012
    It sounds pretty self-explanatory to me. If someone comes in with fevers, chills, n/v, and they complain of RLQ pain with guarding and rebound tenderness, then they probably have appendicitis. They pain would be in proportion to the exam. If someone comes in without all those symptoms and just complains of guarding and rebound tenderness (I don't know if ischemic colitis presents this way, but just for purposes of explanation) then that would be "pain out of proportion to exam." Basically, if they have abdominal pain, but no other causes can be found on PE, IC should be on your DDx.
    MudPhud20XX likes this.
  4. Apoplexy__

    Apoplexy__ Blood-and-thunder appearance 5+ Year Member

    Oct 20, 2012
    Up on the Hydra's back
    Most importantly, the pain comes after eating, and is so bad that it makes them not want to eat. In fact, they're so afraid to eat that they can present with weight loss.

    Recent weight loss + unbearable localized pain to LLQ after meals + bloody stools = Ischemic colitis.
    MudPhud20XX and bulldogmed like this.
  5. bulldogmed

    bulldogmed 2+ Year Member

    Mar 7, 2012
    Duodenal ulcers can present w/ pain after meals leading to weight loss, so you can't jump immediately to IC from that symptom alone.
  6. HatWobble

    HatWobble Rocket Scientist 5+ Year Member

    Nov 27, 2010
    bulldogmed likes this.
  7. bulldogmed

    bulldogmed 2+ Year Member

    Mar 7, 2012
    Is that right? Thanks. I get stuff like that mixed up sometimes. Like bacitracin-sensitive vs. bacitracin-resistant.

Share This Page