73-year-old male with a past medical history of ventral hernia with 3 prior surgeries presented to ED complaining of worsening abdominal pain with nausea.
Day of presentation:
2053: CT demonstrated SBO with thick-walled small bowel loop in ventral hernia.
2218: Observation order placed
2230: H&P assessment: SBO in known ventral hernia, possible incarceration by CT. Patient refusing NG, plan surgery consultation. IV pain meds, antiemetics as needed.
1157: Hospitalist note: Continue conservative management including IV fluids, surgery consult.
1208: Surgery consult: Morbidly obese, multiple hernia surgeries. Feeling better after 3 episodes of emesis and bowel movement. Plan abdominal series, advance to clear liquids.
1223: Inpatient order placed
1245: Abdominal series nonobstructive bowel gas pattern
1008: Hospitalist note- Feeling much better
1214: Discharge to home