FITZ HUGH CURTIS SYNDROME

The Differential Diagnosis Of Appendicitis Is Often Challenging- Why? The overall accuracy for diagnosing acute appendicitis is approximately 80%, corresponding to a mean negative appendectomy rate of 20%. Diagnostic accuracy varies by sex, with a range of 78-92% in male patients and 58-85% in female patients. The classic history of anorexia and periumbilical pain followed by nausea, right lower quadrant (RLQ) pain, and vomiting occurs in only 50% of cases. Vomiting that precedes pain is suggestive of intestinal obstruction, and the diagnosis of appendicitis should be reconsidered. The differential diagnosis of appendicitis is often a clinical challenge because appendicitis can mimic several abdominal conditions. Patients with many other disorders present with symptoms similar to those of appendicitis, such as the following: Surgical Intestinal obstruction Intussusception Acute cholecystitis Perforated peptic ulcer Mesenteric adenitis Meckel's diverticulitis Colonic/appendicular diverticulitis Pancreatitis Rectus sheath haematoma Urological Right ureteric colic Right pyelonephritis Urinary tract infection Gynecological Ectopic pregnancy Ruptured ovarian follicle Torted ovarian cyst Salpingitis/pelvic inflammatory disease Medical Gastroenteritis Pneumonia Terminal ileitis Diabetic ketoacidosis Preherpetic pain on the right 10th and 11th dorsal nerves Porphyria Misdiagnosis in women of childbearing age Appendicitis is misdiagnosed in 33% of nonpregnant women of childbearing age. The most frequent misdiagnoses are pelvic inflammatory disease (PID), followed by gastroenteritis and urinary tract infection. In distinguishing appendiceal pain from that of PID, anorexia, and onset of pain more than 14 days after menses suggests appendicitis. Previous PID, vaginal discharge, or urinary symptoms indicate PID. On physical examination, tenderness outside the RLQ, cervical motion tenderness, vaginal discharge, and positive urinalysis support the diagnosis of PID. Although negative appendectomy does not appear to adversely affect maternal or fetal health, diagnostic delay with perforation does increase fetal and maternal morbidity. Therefore, an aggressive evaluation of the appendix is warranted in pregnant women. The level of urinary beta-human chorionic gonadotropin (beta-hCG) is useful in differentiating appendicitis from an early ectopic pregnancy. However, with regard to the WBC count, physiologic leukocytosis during pregnancy makes this study less useful in the diagnosis than at other times, and no reliable distinguishing WBC parameters are cited in the literature. Also, Read  COVID-19 Differential Diagnosis    

A male pt 24 yr complaing pain in right hypochondrium with liver tenderness, nausea , general weakness , abdominal fullness, anorexia, on investigation results in following plz suggest diagnosis and tmt.

A newly married 25y/f having fever with chills/burning urination/severe constipation with vomiting ..especially morning Pregnancy -ve SGOP 53/ PT 45 Problems persistent even 3 days after oral Levoflox/ alkasip/pcm650/ paranorm/antacid/picosulf...

A 17 y/F come in hospital with C/O Gabhrahat, pain abdominal, backache,and fever history 4 days back, *Chief Complaints* C/O Gabhrahat, pain abdominal, backache,and fever history 4 days back *Vitals* BP -70/40 RR- 24 Spo2 100% HR 130 Temp 98.4 *Physical Examination* On examination abdominal tenderness (+) Puffiness over face Diminished or inaudible breath sounds.but maintain Spo2 100% *Investigations* Report attached *Management* Patient on inotropic support And supporting treatment Please suggest DX and RX

pt with complain of hyperacidity,nausea,vomiting,weakness,vertigo usg shows following suggest t/t,