Concluded Case

A 17yrs Old Female came with Complaints of Pain at Chest region at the time of Menstrual Cycles since 6 months.. Character of Pain - Sudden gripping type & remains for 20mins Pain only observed during cycles only.. CBP, Thyroid Profile are WNL.. What would be the Further Management of this Case..?? This is the USG of that Female (LMP 27/11/2018)..

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Concluded answer
Premenstrual tension with Rt ureteric microlith with hydronephrosis. Plenty of fluids to drink. Cap Tamsulosin 0.4mg HS. Tab Drotin Plus BD. Tab Fruselac daily in the morning. 2days prior to expected date of mens: Tab Clonazepam 0.25mg TDS×4days Tab Drotin Plus & Tab Fruselac as usual even after passing of calculus Repeat USG after 3 weeks.
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Premenstural tension with upper uretric calculi Chest pain during Menses due to hormonal effect Tab placida plus Start 1 to 2 days before Menses X-ray / IVP KUB Urine R /m, CBC Tab vetory D BD x 7 days Cap rabikind D OD x 10 days Tab leon 500 mg OD x 10days Tab cystone forte tds x 1 month Syp neeri 2tsp tds x 1 month Intake Plenty of more water orally Cranberry juice, coconut water, juicses Followup after 1 month USG / IVP KUB No change of report Then Best option URS with DJ stenting
Thanks Dr MD Acharya sir
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Premenstrual tension with Rt ureteric microlith with hydronephrosis. Plenty of fluids to drink. Cap Tamsulosin 0.4mg HS. Tab Drotin Plus BD. Tab Fruselac daily in the morning. 2days prior to expected date of mens: Tab Clonazepam 0.25mg TDS×4days Tab Drotin Plus & Tab Fruselac as usual even after passing of calculus Repeat USG after 3 weeks.
Valuable opinion
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Ask for KUB and Routine URINE and IVP if calculi confirm then start Cap Tamfil one daily for one month Tab Neeri one tds Syrup K mac b12 active two tsf twice daily Plenty of water to drink If she is taking Calcium stop it
Thanks Dr Shital
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Renal stone is a chance finding. Chest pain may be due to breast tissue involvement because of hormonal impact Simple painkillers will be sufficient for it.
Thank you doctor
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Give her pyroxicam NSAIDS... along with ppi. FOR 1st 3 days of menses ... Then mean while treat her renal problems.
Thank you doctor
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RT renal calculus chest mastitis EVion 400 mg no result serum prolactin
Thank you doctor
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Renal calculi
Thank you doctor
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D/D- 1.Distance endometriosis 2.Mastalgia due to hormonal interplay during menstruation. 2. Right sided uretric stone with hydronephrosis. Treatment- 1. Tab. Dinogest-2 mg( fourth generation progesterone) 1 tab. OD for 6 months. 2.Tab. Cystone 1 tab. BD for 3 months. 3.Plenty of fluid.
Vt. Renal calculus chest mastitis. Give Evion 400mg. No result serum prolactin.
I agree
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Trt as that of ureteric calculus
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