Case Studies

Case 6: A 37-year-old woman with abdominal pain (Part 8 The gastrointestinal system)

Mrs Patel, a 37-year-old woman, goes to see her GP for abdominal pain, dyspepsia and vomiting. She also informs her GP that her appetite is poor and she has no energy to do any housework. 'I don't drink any fizzy drinks or alcohol but seem to burp a lot'. The GP informs her that she may have gastritis and will treat her with some tablets.

Feeling relieved, Mrs Patel gets the prescribed medication from the chemist and takes it as instructed. After a couple of weeks of taking the medication, Mrs Patel still has the symptoms as before and therefore decides to visit her GP once again. After examining Mrs Patel, the GP decides to refer her to the local hospital under the care of the gastroenterologist.

Mrs Patel goes to the hospital accompanied by her husband and her two children. She is seen by the consultant gastroenterologist, who carries out some tests and investigations. The results of the tests and investigations indicate that Mrs Patel has carcinoma of the stomach and the consultant informs her that he is going to admit her for surgery. Mrs Patel and her family are shocked to hear the news.

• 1. Discuss the preoperative assessment you will carry out on admission of Mrs Patel to the ward.

• 2. Discuss the risk factors for carcinoma of the stomach.

• 3. Mrs Patel has a nasogastric tube in situ postoperatively. What is the rational for maintaining nasogastric tube aspiration?

• 4. Discuss the immediate postoperative care of Mrs Patel on return to the ward.