Colicky Pain and Vomiting in a 76-Year-Old Woman
A branching clinical case simulation for a patient presenting with colicky abdominal pain, vomiting, abdominal distension, and no flatus for 2 days. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 76 years, female
- Presenting complaint
- Colicky abdominal pain, vomiting, abdominal distension, and no flatus for 2 days.
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are the Year 4 student in the Emergency Department of a district general hospital. Mrs Margaret Whitfield, 76, is triaged with two days of worsening colicky abdominal pain, repeated vomiting, progressive abdominal distension, and she admits she has not passed flatus or opened her bowels for 48 hours. She had an open hysterectomy 15 years ago. Her observations show tachycardia, borderline low blood pressure, and reduced urine output. She looks unwell. You are asked to assess her and decide on initial management.
What this case teaches
Recognise small bowel obstruction; initiate rehydration and NG decompression; interpret abdominal radiograph and CT; identify the need for surgery.
How the case unfolds
- 1Taking a focused historyHistory
- 2Abdominal examinationExamination
- 3Initial investigationsInvestigations
- 4Interpreting findingsDiagnosis
- 5Initial managementTreatment
- 6Monitoring and next stepsMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.