A 17yrs male patient presented with pain in right ilacfossa, vomiting, fever ,taken antibiotics out side after which, pt developed bloody diarrhea, investigation showed neutrophil leukocytosis ultrasound report attached what are the differential diagnosis and what treatment u will advise

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Get a CECT abdomen further evaluation. D/D - 1.Enteritis with non - specific mesentric lymphadenitis. 2.Ileocaecal tuberculosis. 3.Appendicular carcinoid. Treatment- IV fluids Parenteral antibiotics Cetriaxone 1 gm and Amikacin 250 mg B.D for 7days Further treatment depends upon the CT report.

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Differentials for rt iliac fossa pain with bloody diarrhoea are Iliocecal tuberculosis Crohns disease Acute appendicitis Malignancy is rare Best would be doing colonoscopy and tissue biopsy from terminal ilium and ceacum..

Tuberculosis
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? Ileocecal tuberculosis ? ? Appendicular carcinoid Adv CECT...ABDO. Inj ceftum 1 gm iv bd inj mila in 500 mg bd, with Iv fluid inj stemetil ,inj aciloc + , multivitamins + PCM for 5 days than assessment should be made after receiving reports.

Thanks Dr sachin
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DD s... Medical causes of dysentery viz.. Bacterial enterocolitis Amoebic typhlitis Shigella, salmonella, etc IBD TB Appendicitis complicated Please get.. CECT Abdomen Stool routine and calprotectin Sigmoidoscopy or colonoscopy Bx Once diagnosed... plan definite Rx

Typhoid is my first differential Then ibd Tb Pseudo membranous colitis usually presents with diarrhoea. Bleed is rare. Go for cect abdomen Colonoscopy biopsy Antibiotics Antispasmodic

Sir, circumferential thickening is seen in tuberculosis rather than typhoid....
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ileocecal tuberculosis with acute enteritis.Put pt.on conservative treatment,NBM,IV fluids, Antibiotic cefaperazone-sulbactum,IV metrogy,IV paracetamol,IV Pantocid with Injection Streptomycin 0.75 gm IM OD after sensitivity testing with zinc & protein,will be sufficient.If we suspect carcinoid tumor of appendix which is rare,then do surgical appendices Tony and send for HP examination.If we consider mucoid tumor of appendix (mucocoele), then do appendices Tony safely without rupturing mucocoele,if mucocoele involves surrounding ascending colon & adjacent lymph nodes enlargement,then we have to do hemicolectomy

D.D. 1.Ieocaecal tuberculosis 2.Appendicular carcinoid.

Duration? If chronic or recurring... TB, IBD If recent.... bacterial enteritis

4 year old child with vomiting and blood stools with fever think of intusception first U S alone will not confirm it C T Abd and colonoscopy mandatory in the mean time I V fluids Antibiotics will help in stabilizing the baby.

D/d ...1. abdominal tuberculosis 2. Crohn's disease. 3.shigella dysentery

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