ACUTE CHOLECYSTITIS Č CHOLELITHIASIS

A 27 years old female handicapped patient, complaining with pain abdo. nausea č vomiting, pain at right hypochondriac region, and such complications, like irregular menstrual bleeding, clotting blood.

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As the PT having two main pathological finding in USG ( a). Cholecystitis with cholelithiasis (b). Haemmorhagic ovarian cyst Pt in acute stage of pain abdomen vomiting , both the conditions cause pain abdomen so conservative treatment to be started Nil by mouth Iv drip to continue to rest to digestive system and to maintain nutrition Antibiotic broad spectrum in parenteral form Antispasmodic Investigation Blood for complete examination Blood for LFT and serum amylase Blood sugar to see glycaemic condition of pt Once the acute condition settles may be taken up for cholecystectomy after 4weeks Ask for opinion for ovarian cyst.

Thank you so much respected dr. Mrinal sir
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1..Pain abdomen,Nausea and Vomiting:-Causes Acute Choleccystitis ₩ Cholelithiasis. 2..Irregular periods:- causes Haemorrhagic Rt Ovarian cyst. ------I think 1st Choice must be to Control Pain& Vomit..As you w'll be treating. Iv fluid with Antibiotic inj. Inj.Pantop Inj.Vomikind Inj.Dynapar/Antispasmodic Orally Ranidom-O Syp 10 ml tds. As Patient w'll be stable Do Cholecystectomy. -----For Haemorrhagic Ovarian cyst I think You Kmow Much better Sir

Thank you so much dear msw
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Acute cholecystitis with cholelithiasis with rt haemorrhagic ovarian cyst Admit patient Preoperative investigation NPM IV fluid BS antibiotics Inj Ondansetron Inj Pantaprazole Inj Drotavarin Inj Diclofenac im sos After control of infection plan for Laparoscopic Cholecystectomy & Ovariectomy

She has multiple problems Gallbladder thickening with multiple stones and attributes to present complaints and need removal of gallbladder as earlier as possible Second problem is of MC that is bcz of hemorrhagic ovarian cyst which also need surgical intervention Both problems are to be done step by step

Thanx dr Taimoor dr Taimoor
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GO FOR CHOLECYSTECTOMY FOR CHOLECYSTITIS/CHOLELITHIASIS AFTER COMPLETE SURGICAL PROFILE- INVESTIGATIONS AFTER SYMPTOMATIC TREATMENT OF ACUTE PHASE A HEAMORRHAGIC CYST DISAPPEAR ITSELF WITH OUT ANY SPECIFIC TREATMENT ...SO REPEAT USG ABD-PELVIS AFTER 2-3 MONTHS.... TILL THEN MANAGE SYMPTOMATICALLY DURING MENSTRUAL PERIOD

Thank you doctor
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Admit her and go for CBC ESR Blood SUGAR HIV HbSAg LFT VDRL Serum Amylase and Lipase treatment Nil orally, Injection Monocef 1gm iv bd, Injection Pan 40 one vial iv , Tab Fortibile 300 bd ,Tab Pancreoflat one bd, Injection Dilona Aqua one amp IM sos, And for ovarian cyst give Tab Pristal 5mg one daily after subsiding pain after one month go for Cholecystectomy

Thank you so much respected dr. Ramesh sir
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As its confirmed of having Cholelithiasis, only alternate to go for Cholecystectomy. You get all neccessary investigations as par Surgeion's recommondation and start antibiotic coverage.

For ovarian cyst only follow up start on antibiotics and plan for cholecystectomy

Thank you doctor
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Cholelithiasis needs cholecystectomy Hemorrhagic ovarian cyst tab Pristol 5mg od and keep observation ,ovarian cystectomy if no response

Thanks Dr. Sabista
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Needs hospitalization Antibiotic and hormonal pills for cyst and for pain inj dyanapar sos. Cholecystectomy

Thank you so much respected mem
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