Abdominal Pain And Fevers in A Shunted Patient

Consult Page

48F here with abdominal pain, low grade fevers. CT abdomen shows multiple abscesses

Initial Imaging

Walking Thoughts

• ■

  What is the patient’s neurological exam and current vitals?

• ■

  Does the patient have any neurological symptoms? Is she exhibiting any signs or symptoms concerning for sepsis or meningitis? What is the timeline of symptoms?

• ■

  Why does the patient have a shunt? What is the patient’s shunt history?

• ■

  When was the shunt placed?

• ■

  What type of shunt is in place?

• ■

  Has the patient ever required a shunt revision and if so, when was the last one?

• ■

  Has the patient ever had a shunt malfunction? If so, what symptoms did the patient have at that time?

• ■

  Has the patient had a shunt-associated infection before?

• ■

  Has the patient had a recent abdominal procedure?

• ■

  What bloodwork has been sent? What other imaging does the patient need?

• ■

  Does the patient need an urgent bedside procedure (e.g. shunt tap or externalization)?

• ■

  Does this patient need to go to the operating room for a shunt revision? If so, what is the timing of surgery?

• ■

  Does the patient have other medical comorbidities?

• ■

  Is the patient on any antiplatelet or anticoagulant medications?