Author: Bryan Orji / Editor: Stephen Sheridan / Codes: GP2, GP4, OncC1, OncP1, SLO3 / Published: 29/12/2025
A 56-year-old lady with Williams syndrome, presents to the Emergency Department (ED) with mild abdominal pain and distension, reporting she is unsure if her last bowel movement was 2 weeks ago. She is passing flatus and has noticed her pads being stained with small mucoid-like fluid. She is afebrile, not vomiting and generally ‘feels fine’.
No previous surgical history and takes sertraline and omeprazole.
The patient lives in supportive accommodation, requiring 24hr carers and assistance with all ADLs.
On examination:
HR – 98/min,
RR – 18/min
SpO2 – 96% on room air
BP – 143/110mmHg
Temperature – 37.2
Abdomen: markedly distended, generally tender with no guarding. Bowel sounds are hyperactive. She refuses a PR exam because she ‘feels uncomfortable down there’ Routine bloods completed are unremarkable.
2 responses
Good case , thanks
Its always very challenging to take history from patient who are diagnosed with learning difficulties, its like hunting for gem stone to rule out every possible cause of presentation.
Very good precise case.