Diffuse abdominal pain

A 21 year old female came with abdominal pain, nausea & 2 episode od vomiting with blood. She was feeling tired and lazy everyday lately. She has a history of recurrent UTI. She has no history of any other medical condition. Temp: 100.0º and heart rate 125 bpm. Physical examination shows a distended and tender abdomen. All other examination aare well. Labs shows normocytic anemia with 10.1 gm/dL HB, albumin was 3.2 gm/dL, lactate was 1.71 mmol/L and the INR was 1.14. X-ray NAD. CT scan of the abdomen showed ascites with stranding in the omentum and peritoneum which was thought to be peritoneal carcinomatosis. All other imaging were normal. How should we proceed with the case?

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First do an UGIscopy to look for the site of bleeding and control it. Then you can do USG guided aspiration of the ascitic fluid with R/M and cytology and then proceed further accordingly.

First tapping of ascites and send for analysis. CA 125 for Malignancy . Till reports complied. Symptomatic treatment.

Thanks Dr Dinesh Gupta

Go for tapping of ascites usg guided cbnat Pet scan Cea blood test malignancy

Ascitis tapping, send for investigation PET scan needed CA 125 test for malignancy

Ascites tapping. Pet scan and check for tumour markers

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