29y o male personal history alcoholic c/o fever weaknesh n abd pain with vomiting 3 dsys ago.. present pt c/o several abd pain no fever pt c/o blood in urine ( hematuria ) hb 14 tc 2300 plt 170 mp not sgpt 30 usg attach repeat cbc send.. what your opinion doctors.. I

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As TLC is 2300 it is unlikely to be acute appendicitis. Also no fever that goes against acute appendicitis. Probe tenderness right iliac fossa can be due to amoebic typhilitis, ileocaecal tuberculosis. Crohns disease. These diseases are missed in USG A CECT abdomen is indicated . Hematuria,with pain abdomen could be due to recent passage of an impacted calculus in the ureter. USG must have been done after the passage of calculus.

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Cystitis, bladder infection , causing lower abdominal pain, fever and hematuria. Since TLC shows leupenia, viral infection like DENGUE have to be ruled out In abdominal pain in alcoholic, 2 DDs Acute pancreatitis, and Idiopathic bacterial peritonitis. Serum Amylase and Lipase can be checked .

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As per history and reports there is a chance of acute abdomen likely to be due to acute appendicitis.. or Urinary tract infection as hematuria is also present... I would suggest start on broad spectrum antibiotics , IV fluids and analgesics .. Review after 48 hours and decide regarding further management

Pt is having pain abd with rise of temp 3days and haematuria. But the USG report no significant organ envolvement except probe tenderness Rt lower abdomen ,it may be case of acute appendicitis and haematuria due pelvic type of appendix causing irritation of the ureter resulting blood in urine. Repeat CBC, though total count not suggestive. Go for one CT abdomen IV drip IV inj ceftraixone 1gm IV bd IV metrogyl one bottle bd Inj antispasmodic did Wait for CT report and clinical assessment of the case.

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cbc report same wbc 2300 amylase normal