Wednesday, October 26, 2016

Inflamatory Bowel Disease in the ED

emDocs - October 25, 2016 - Authors: Trueblood W and Simon E
Edited by: Koyfman A and Long B
"IBD is comprised of Crohn’s Disease (CD) and Ulcerative Colitis (UC). Crohn Disease is characterized by transmural inflammation of the bowel wall anywhere from mouth to anus. Ulcerative Colitis is inflammation limited only to the colonic mucosa, in a continuous fashion from the rectum to the cecum...
Key Pearls
  • The role of the ED physician is to resuscitate, stabilize as necessary, evaluate for surgical pathology, and consult for further management.
  • Imaging modality of choice for an IBD patient with abdominal pain => Abdominal/pelvis CT with IV and oral contrast
  • Unless concern for perforation/megacolon => acute abdominal series to expedite management
  • ED treatment priorities: pain/nausea control, correction of electrolyte imbalances +/- antibiotics given the clinical scenario
  • Disposition => outpatient vs. inpatient in consultation with GI consult"