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CaseStudy241116 -

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24 Nov 2016 - General
 

A middled aged gentleman, with the background of hypertension, asthma, hypercholesterolaemia, smoker of 10 pack years history, was admitted to hospital due to worsening right sided abdominal pain, and diarrhoae. According to patient, she experinced acute onset of right sided abdominal pain around 4 days ago, which was followed by waterry diarrhoae. Initally, the abdominal pain was relieved by analgesia - paracetamol. However, the right sided abdominal pain was worsening since a day before, with rate 8-9 / 10. She also has waterry diarrhoea around 6-7 episodes per day, since the onset of abdominal pain. On examination of her abdomen, abdomen was very tender and with rebound tenderness. Urgent CT-ABD & Pelvis was done (to rule out intra-abdominal pathology or perforation), showed likely mild pancolitis. There was no bowel perforation. Her blood tests showed elevated white cell count and inflammatory marker. What is your working diagnosis ?? What other investigations are neeeded??

Yes Marinelle Castro , performing a full colonoscopy for patient with acute colitis may be risky due to the higher risk of bowel perforation. If endoscopy procedure is really required, then...
 (Total 121 words)
You Yi Hong From what I learned in medical school, performing endoscopy on a patient with diffuse inflammation of the bowel increases the risk of bowel perfortation. For this reason, I hav...
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Yes Marinelle Castro &Mark Edmon Tan , acute appendicitis / rupture appendix / appendiceal abscess is definitely the crucial...
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I just remembered what criteria we used during my duty days in the Emergency Room. It's called the Alvarado score or the MANTRELS Criteria. The score has 6 clinical items and 2 laboratory measurements with a total 10 points. MANTRELS is a mnemoni...
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You Yi Hong I have encountered similar cases, and there is a possibility that this is a case of an intraabdominal abscess caused by a ruptured appendicitis. The patient had a history of ri...
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This sounds like a case of acute abdomen secondary to appendicitis. Acute severe abdominal pain is one of the hallmark symptoms of appendicitis. The other common symptoms are anorexia, nausea, and temperature elevation. The acute abdominal pain usual...
 (Total 115 words)