13yrs boy c/o severe lower and pain in illiac region with nausea .. No tenderness Reports attached Can I give oral nd iv antibiotics or emergency surgery shld be adivised ???
Only symptomatic trestment.. The most common cause of mesenteric lymphadenitis is a viral infection, such as gastroenteritis — often called stomach flu. This infection causes inflammation in the lymph nodes in the thin tissue that attaches your intestine to the back of your abdominal wall (mesentery). Mesenteric lymphadenitis often gets better without treatment. Still, you may need medicine to reduce a fever or control pain. Rest, fluids, and warm heat applied to the abdomen may also help relieve symptoms. You may need treatment for the cause of the inflammation.
Radiologist hasnt mentioned the size of lymph node . But sometimes pain is so severe it mimics appendicitis . Take history of contact with tuberculosis . Cbc crp esr urine r/e n c/s. No surgical intervention is needed at all . Do counsel the patient for the same . U can give inj ceftriaxone 1 gm twice daily along with amikacin and metrogyl . Inj tramadol for pain iv fluids n antiemetics like ondasetron . Add probiotics.
IT'S A..CASE OF.. PAIN IN ABDOMEN.. ILLIAC REGION.. ? APPENDICITIS.. ? MSENTRIC LYMPHADENOPATHY.. ? WORM INFESTATION.. * PRESENTLY TREAT WITH.. ANTIBIOTICS AS PER REQUIREMENT.. AND.. ANTISPASMOTIC .. DEWORMING WITH ALBENDAZOLE.. INVESTIGATIONS..SOS.. HEMOGRAM.. URINE ROUTINE.. CTCE STUDY..
Mesenteric lymphadenitis Age & complaints (though fever not mentioned or absent) s/o Acute appendicitis Keep under observation Further clinical correlation is necessary Antibiotics IV fluid Ondansetron Drotavarin
Mesenteric lymphadenitis causing pain usually subside with conservative treatment, surgery is usually not required Oral antibiotics will help
Mesenteric adinitis ? Bacterial ? Viral Suggest CBC, CRP , Lymph nodes are sub centimeter, and difficult for FNAC Antibiotics, PPI, Tinidazole , antispasmodics, UV fluids
Give symptomatic treatment with antibiotics. Clinicaly examine appendicitis with Rebound tenderness, Rovsing sign, Obturator test, psoas test, Tenderness in Rt iliac fossa, Blood investigation Haemogram - Raised WBC count, Alvardo score .As few appendicolith present which may inflammed appendix in future, may go for prophylactic appendisectomy
its mesentic lymphadenitis...rule out abdominal tuberculosis....CBC,ESR,gastric aspirate for CBNAAT(2 early morning samples).. if above reports normal...start oral antibiotic and symptomatic treatment...there is no need of surgery...
NPM IVF with RL: NS(1:1)- IV BD Inj Ondem (4)- IV TDAC Inj Cefriaxone (1g)- IV BD (APST) Inj Pan40- OD Inf Metrogyl 100- IV BD. Inj Drotin- IM BD Investigation: blood for CBC ESR. Follow up.
Inj cefotaxim and sulbactum,drotin sy, metronidazole tab
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