Lower abdominal pain

Chief Complaint A 38 y/o male presented with the complaint of lower left quadrant mild to moderate abdominal pain for 3 days. The pain was continuous, sharp in nature. No other complaint like vomiting or weight loss . History No past medical or surgical history. No relevant family history. Examination Abdominal mass in the right lower quadrant was noted on physical examination. Investigation WBC: 13.7 ×103/μL. CT shows a thick edematous bowel loops in cecum and ascending colon. Treatment Please give your opinion.

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Leucocytosis Ct abd suggest ileio cecal thickening and oedematous Suggestive of infective aetiology and inflammatory bowels Likely a c/o entericolitis Rx broadspectrum antibiotics iv drip Inj dexamethasone Inj meteronidazole Inj pantaprazole inj ondestron Inj diclofenac Once settled down shift on oral treatment

Thanx dr Kute Ankush

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Abdominal mass in right lower quadrant and CT showing thickening of caecum and ascending colon Differential diagnosis Tuberculosis Amoebic colitis Inflammatory bowel disease Adv Colonoscopy and biopsy for histopathological diagnosis

Here are possibilities Tuberculosis ileocarcal Appendicular lump Papas abcess Carcinoid Amoebic colitis Malignancy Identify the cause and treat accordingly


DD Ileocecal TB Malignancy Inflammatory bowel disease Amoebic colitis Appendicular mass Carcinoid Suggest CT with contrast Scopy - colonoscopy , capsule enteroscopy with biopsy.

Crohn disease or bowel obstruction can cause many tender, sausage-shaped masses anywhere in the abdomen. Diverticulitis can cause a mass that is usually located in the left-lower quadrant. Gallbladder tumor can cause a tender, irregularly shaped mass in the right-upper quadrant

*Tubercular ** Amoebic colitis I B S Needs further investigation and evaluation to conclude and line of treatment.

Thanks Dr Kute Ankush

As described by Dr. Shivraj it appears to be infective etiology ...presently pt does not hv obstructive symptoms. May be abdominal Kochs

? Intestinal tuberculosis


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