6 year old girl, complaints of headach, abdominal pain with bloody stool and frequent constipation, fever since 20 days....CBC normal, widal normal, probable diagnosis??

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In this age intusuception is common. Ultrasound may exclude the condition. But the patient should be treated in the line of bacillary dysentery. of 200mg bd, metronidazole 200mg tid and lactobacillous preparations be given


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I think we r looking for a febrile illness which is not localised.c this history we will do USG to look for caseating intraabdominal lymphnode to rule out abd Koch's. Other important investigation will be colonoscopy and biopsy of any ulcerative lesion if its there to rule out inflammatory bowel disease.

First clinical diagnosis is Enteric fever with bleeding from terminal ileum. Differential diagnoses are Infective colitis, Polyps, Tuberculosis, Henoch Sconlen Purpura, CNS infection with anal fissure.

Investigation of abd pain CBC ESR Mt stool RT culture and sensitivity CT abdomen with contrast then decide alternate constipation with loose motion chance of Tb abdomen

Need more detail history & investigations like ESR, Mx test, USG & CT Abdomen, Colonoscopy. Mostly abdominal tuberculosis or IBD

Pain abd headache frequenut constipation for 20days.USG WA Mantaou test h\ of cotact to rule out abd koch's.

Age group of 3month to 3year of intussusception may occur at older age but then pathological lead point present Abdominal tb usg, ct mtx should be planned

get x-ray fpa and PR examination then proceed .mostly it is colitis or may be part of IBS.treat conservative.

USG normal...Urine routine shows several pus cells...patient was on higher antibiotics prescribed by some other paediatrician...Bloody stool was may b due to higher dose of drug...After discontinuing the drugs patient is bit stable

what is X ray finding? can u post X RAY film?

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Do a rectal examination to rule out intussuception and rectal polyp. Plain X-ray abd in standing position. Possibly it is intussuception. A low pressure, thin Barium enema may help diagnose intussuception or show necrotizing enterocolitis. ( but barium enema is risky , if not carried out with extreme care and gentleness)

it could also be typhoid fever with enterocolitis (hemorrhagic).
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