Wilderness Medicine Case Study 47

You are leading a two-week canoe trip in the Boundary waters of northern Minnesota. On day seven of the trip, one of your female students, Jane, suddenly sits down next to her canoe just prior to entering it after lunch. When you reach her she complains of abdominal pain (4 out of 10). She tells you her menstrual period started yesterday with bloating, cramping, and mild abdominal pain and, although it is slightly worse right now, it's pretty normal for her. She adds that she is unusually tired today and while she had a normal bowel movement this morning, she found it difficult to urinate. An abdominal exam reveals tenderness in both her lower quadrants; her lower back is non-tender. She reports that ibuprofen and rest usually help.

What do you think is wrong with Jane and what should you do about it? Click here for answers. 

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