34y female pt suffering with sever pain abdomen and. vomiting fever please suggested further evaluation and treatment
Diagnosis is more important before coming at a conclusion. Meanwhile symptomatic treatment can be started . As Ultrasound abdomen is normal history and clinical examination becomes important. D/D - Acid peptic disease Acute gastroenteritis. Acute early pancreatitis Enteric fever Worm infestation Acute appendicitis Response to conservative treatment is important for further management with IV fluids, inj cetriaxone 1 GM B.D , inj Pantoprazole, antispasmodic. NPO till pain settles.
Severe pain abdomen associated with fever & vomiting. USG normal study. DD 1 Acute appendicitis 2 Abdominal migraine 3 Acute colitis 4 Acid Peptic disease 5 Ulcerative colitis/Diverticulitis/Crohn's disease. 6 Round worm infestation 7 Sub acute bacterial peritonitis. 8 Early pancreatitis Clinicopathological correlation is required. Investigation accordingly. Treatment: NPM Inj Cefrrixone 1 gm IV BD (AST),IV fluids RL/DNS 5 hourly,Inj Metronidazole 500mg IV 8 hourly,Inj Gentamicin 80mg IV BD,Inj Onsansetron IV stat & SOS,Inj Drotavarin 80 mg IV TDS,Inj Tramadol 100mg im SOS,Inj Pantaprazole 40 mg IV BD.
*APPENDICITIS.. * AC. PANCREATITIS.. * GASTRITIS, ACID PEPTIC DISORDER.. NEEDS CLINICOPATHOLOGICAL EVALUATION IN BRIEF WHICH IS MISSED IN USG STUDY ABDOMEN.. BLOOD HEMOGRAM.. BLOOD PANCREATIC ENZYME STUDY URINE ROUTINE.. REPEAT USG STUDY ABDOMEN CTCE MRI STUDY ANGIOGRAPHY STUDY.. MEANWHILE TREAT WITH.. ATISPASMETIC INJECTIONS.. DICLOFENAC ANTIEMETIC'S.. IV FLUIDS SOS.. SYMPTOMATICTREATMENT.. FOLLOW AS PER REPORTS WITH EXPERTS OPINION..
Take the proper history of fever ,pain abdomen and vomiting ..... And do CBC and widal And put patient on conservative management NPO IVF Inj ceftrixone BD Inj cipro BD Inj metro TDS Inj tramadol BD Inj rantac BD Inj Perinorm ....
USG normal Any warm infection Acute gastroenteritis Acute pancreatitis Acute appendicitis Due to the cause of enteric fever Give conservative treatment with IV fluids Inj.Ceftriaxone 1g IV bd Ink.Pan40mg In.Emeset IV metrizyl Ink.cyclopam IV.PCT
Inj. Pantop 40mg 1 vial iv twice a day Inj. Reglan 1 amp. iv thrice daily Inj. Xone XP 1 vial iv twice a day Patient should be nil orally till nausea or vomiting subside iv fluids continue LFT should be investigate
? Appendicitis Inj monocef 1gm BD x 5 days Inj metro 100ml tds x 5 days Inj voveran tds x 3 day Inj pan 40mg BD 5 days Inj emset tds x 3 day NBM till control vomiting & pain IVF DNS, RL D5% + multivitamins After 5 days Soft liquid diet coconut water, ORS powder, juicses Tab zanocin oz BD x 5day Cap rabikind D 1 BD before meal x 5 day Tab vetory D BD If pain ADV CT SCAN ABDOMEN SOS Maintain personal hygiene Improve general body health Intake Plenty of more water Avoid constipation and indigestion Avoid oilly and spicy food egg fish chicken burger fast food pizza etc Uses Fibres Green leaf vegetables and fruits papaya banana etc
Clear history is not given, Appendicites, Colitis, pancreatitis, Typhoid, Acute abdomen May be, Symptomatically Antibiotics, Antianarobic, antiematic,may given
R/0 a cute pancreatitis Lft rft cbc serum amylase ldh Antigen malaria typhi Then decide line of Rx
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