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No longer hear abdominal bruit --? AAA --? aneurysm
I have been a nurse for 14 years. Until this year, I had only worked with adults. Now I'm a school nurse. I encountered something I've not in the past. I heard what sounded like an abdominal bruit that disappeared on a child complaining of abdominal pain. Naturally I listen for bowel sounds. Right away I hear a pulsing swish in the epigastric area. I have them stand and hear the same. Had them lay supine and still hear it. I know it wasn't lung sounds and sure didn't sound like bowel sounds...it was rhythmic. I have heard bruits before and this sounded the same. My question is this, why would I no longer hear this after they ate lunch? They come back after lunch and all I could hear was bowel sounds. Can bowel sounds drown out the sound of an abdominal bruit? I would think so, especially because the aorta runs behind the stomach, bowel. But I can't find any literature that confirms this? This is driving me nuts. I hope for the child's sake I didn't truly hear a bruit but want to know I'm not crazy. Of course, I played it safe with this child but hope I've not just concerned people when I shouldn't have.
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@nurse82
Welcome to Connect!
It sounds like you are a very good school nurse. You actually examine the patient properly.
Regarding your student patient it sounds very likely that a full stomach and bowel sounds could obscure a bruit. Was there a heart murmur?
Did you let the parents know what you found? It would be good for the child to be examined by their pediatrician.
Don’t beat yourself up- you are an excellent and caring nurse.
Can you let us know what the outcome is?
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3 ReactionsI second @astaingegerdm in that you sound like you did a very thorough job. This does sound like such a specific scenario that the family would be best suited to be alerted and following up with a medical professional would be a good cause. Perhaps you can share information like requesting an appointment, http://mayocl.in/1mtmR63 with them?
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1 ReactionThank you for responding and to you @JustinMcClanahan. I had told the parents that day in the best way to not scare them and stressed the importance of following up, especially since I had seen him 3 times for belly pain and he hadn’t followed up with anyone the previous times. I told them that I couldn’t explain exactly why I heard it and then I didn’t but it’s better to just have him checked.
I do know that they did follow up with their PCP and they did not hear it so I don’t imagine further testing will be ordered but hopefully whatever I heard won’t be a problem for this fella. I imagine I will be seeing a lot more of this kiddo so I’m curious if I will ever hear it again. But the doctor probably thinks I’m crazy so don’t know that it’d be worth mentioning again.
You have made me feel better so that I don’t think I’m crazy. Thank you all so much.
@nurse82
It’s good to hear that the child’s doctor didn’t find anything.
You heard what you heard and did the right thing and nobody is going to think that you are crazy!
If the boy keeps coming in for stomach aches you should remind the parents to have that checked out.