Abdominal pain & fever

Chief Complaint 69 year old female presented with the complaint of abdominal pain, vomiting, fever, malaise, shivering, and a feeling of unease after colonoscopy. Vitals BP: 110/80 mmhg, Resp rate:14 breaths per minute, Pulse: 69 bpm, Temp: 97.6 degree C, saturation was ~80% with nasal cannula. Examination She looks little pale on examination. Investigations The initial chest radiograph was done which shows patchy alveolar infiltrates in the left lung. What else do you see? Treatment How should we manage?

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Floppy opacities lt lung field or GGOs with hyperinflated lung fields on rt side Minimal pleural effusion is seen on lt side Pulmonary oedema with effusion Event occured post procedure colonoscopy Pt is hypoxic Two possibilities 1 post procedure event of pulmonary embolism and sequele 2 pre procedure pt was febrile and likely viral covid inf going in pulmonary oedema Rx increase ventilatory support to 7lits of 02 Subject to lab investigations like cbc esr crp sr ferritin and D-dimer Adv ecg Rx inj Ceftriaxozone Inj dexamethasone Inj lasix If covid positive rt pcr Inj Remdesivir Sos inj tocizumab and plasma antibody It is emergency and you have to take all steps urgently

Thanx dr Asad Zaman Leemon
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POSSIBLY CHRONIC .. LUNG. DISEASE.. CONSOLIDATION@ .....EMPHYSEMA ...PULMONARY. EDEMA ADVISABLE... RULE. OUT... ..COVID. 19 AND SEPSIS

Pulmonary oedema with pleural effusion. Consolidation with emphysema Post procedure colonoscopy. Needs further investigation and evaluation to conclude till reports complied symptomatic treatment. Regular monitoring and constant evaluation required. Possibility of any eventuality must be ruled out and under present circumstances covid 19 Infection must be followed and ruled out.

Thanks Dr Kute Ankush
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Apparently COPD and emphysema of unknown etiology Advise sputum, FNAC, CBC,RBS,kft, COVID-19

Thanks Dr. Dinesh Gupta, Dr. Ashok leel, Dr. Sandeep Ghodeker
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? VIRAL PNEUMONIA.. ? COVID-19..

Tnx Dr Ashok Leel sir
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*Consolidation with Emphysema Trachea shifted to right, mild PE ( may be occur conscience of colonoscopy) with partially fibrosis, features indicates Lung cancer and chronic lung disease. *Both domes of diaphragm seen at the same level, Sub-intestinal obstruction seen,features of hiatus hernia noted,atrio septal defect can be possible,Portal HTN may rise. Mx: It's an emergency case, ●Do FNAC,ABG, Broncho evacuation test, CEA/ CA -125, CBC,RBS,LFT,S.CREATININE, ECG. ● Strictly monitor All vital signs, SP O2, Input-output etc ● Pt. Hypoxic, Must have Proper ventilation. ● initially follow conservative and Symptomatic treatment. Call Pulmonologist for better treatment. --Thanks.

Consider COPD emphysema with neoplastic vs Infective etiology.

Aspiration Pneumonia Diffuse Consolidation

Multiple consolidations ? Covid

Multiple consolidations ?covid

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