A 17 yo male presented with severe lower abdominal pain to ER

This might be the first time I've ever discussed a real case here, go easy on me.

A 17 yo male presented with severe lower abdominal pain to ER in a rural area(only place available there), It's 3 am and you are about to sleep while standing. How would you approach this patient? What questions do you ask him
 
Full HPI, full undressing, palpation/location/tenderness/distention/guarding, etc , rule in/out bleed, if concerned use US. obvious top DDX with limited info is appendicitis.
 
My history taking evolves depending on how the patient answers. Have to do that, not just follow a Performa because you'll be asking them questions for ages.
 
It is rural area US only available in private clinics, its 3 am so they are not open. On palpation you can feel something moving every 20 sec in lower abdomen especially in hypogastric, little to no distension, there is little tenderness in lower only, no guarding no bleeding.

The patient has had diarrhoea 3 times since evening, in fact the reason you are about to fall asleep is because diarrhoea has become endemic in the last 10 days.
 
No vomiting, no nausea, the patient admits he ate something outside in evening and pain has become progressively worse.

There is little to no tenderness else where, urination is normal.
 
Top