respected doctors... age-15y/F, C/O- Pain in right lower abdomen (intermittent), nausea since 3 days. underwent USG (abdomen & pelvis)... kindly tell me diagnosis and management

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D/D - Amoebic typhilitis Recurrent appendicitis Non - specific mesentric lymphadenitis. Difference between appendicitis and NSML is tenderness at MCburney,s point in appendicitis- deep tenderness, while in non- specific mesentric lymphadenitis there is shifting tenderness. Treatment- conservative Tab Ornidazole 500 mg B.D for 5 days Tab cefuroxime 250 mg B.D for 7days AN antacid Deworm the patient
Thank u sir
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It should be appendicitis which can be usually diag by clinically. You will be best judge. L node is insignificant. Start Antibiotic, analgesic, antiemetic. I would like to add metronidazole in this case
K sir
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Pain is intermittent in rif with nausea most likely subacute appendicitis cbc urine shoul be helpful sofar usg shows subcentimeter lymphnode seems to be insignificant
K sir
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Appendicitis/mesenteric adenitis, CBC,ESR and mountoux to be done
Mesentric adenitis conservative management
Pain intermittent means either it is renal biliary or intestinal menstrual history pain rt lower abdomen is rt iliac fossa target is10 disease appendicitis is clinical dignosis probe tenderness test while usg sometimes rt ureteric calculus missed on usg best xray or ivp barium RIF tor/0 Koch's abdomen as their is lyphadenitis in rif ideal is biopsy HP ct abdomen pelvis basic cbc esr urinert stoolrt lft rft LDH serum amylase then treat appendicitis dd tb abdomen or tb lyumphadenitis dd amoebic colitis dd salpingitis dd rt pelviuretric calculus dd lymphadenitis may be neoplastic
I agree with Dr.Saurav Clinical evaluation of pt ..must Look for tenderness at Mcburneys point Most likely appears to be appendicitis If doubtful manage conservatively with I.v.antibiotics and see response
K madam
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I agree with Dr SK Das. U r the best judge. While examining locally/palpating u will get rebounced tenderness at rif region.
I did examination, tenderness in mc berny's point.. clinically lm suspecting ac appendicitis but USG report is different sir...
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Sub acute appendicitis.Tab Ofloxacine-Ornidazole bd,Tab Drotavarin bd,Tab Pan 40 of,Tab Onsansetron bd.
K sir
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Mesenteric lymphadenopathy.... give ofloxacin and ornidazole, treat symptomaticaly... it ll subside
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