Further history revealed having fevers and sweats and she denied opening her bowels for 2 days and had pain in the RIF. She denied vomiting, previous PID and pregnancy.
Her observations on arrival were:
P 140 BP123/70 RR 20 Sa O2 98% - room air
Temp 38.5 GCS 14 (V4)
IVDU - currently using - Ice and amphetamines
Renal Failure - undifferentiated
Chronic chest pain following MVA 10 years ago
Triaged Category 3 and assigned to a cubicle. She was seen by a doctor 105 minutes after arriving.
On exam she had stigmata of recent IVDU. Abdomen was "soft" with tenderness in the right iliac fossa and hypochondrium.
As part of her initial work-up she had an abdominal x-ray requested "tro SBO".
What is the utility of a plain abdominal film in a patient with sepsis?
What abnormality does the image show?
Answer next week.