What caused Hematochezia in this case?
Chief Complaint A 31 y/o female presents with the complaint of abdominal pain, vomiting, and hematochezia. History She had h/o surgery for appendicitis. Vital BP: 110/60 mm Hg, Pulse: 98/min, Temp: 102.2 °F, Oxygen 94% on room air Examination Bowel sounds present. Abdomen is tender to palpation. Investigations WBC: 15,500/mm3 Hb: 12.1g/dl Platlets: 318,500/mm3 ESR 29 mm/hr C-reactive protein 11.5 mg/dl BUN 13.5 mg/dL Creatinine: 1.6 mg/dl Glucose: 99 mg/dl CT andomen shows diffuse thickened colon. Treatment Please advise
Sudden onset of hematochezia,( passing of fresh blood in or with stools) with abdominal pain and vomiting. Pyrexial Leucocytosis, raised CRP , Minimally raised Creatinine. Tender abdomen DD Inflammatory bowel disease, more likely, Ulcerative Colitis. DD Diverticulitis with bleeding Ectopic peptic ulcer tissue in large bowel.
Pain in abdomen, fever, raised WBC count, raised creatinine point to bacterial source of infection, probably secondary to appendicular abscess which is not resolved Appropriate antibiotics, IV fluids, and nil Oak intake to give rest to colon may help.
Sepsis following Appendectomy is not fully resolved. Colon seems to have perforated... I classroom of diverticulum caused bleeding. Surgeon's opinion is a must in this case.
? ACUTE ABDOMEN.. ? BOWEL PATHOLOGY.. ? COLITIS.. NEED'S.. CTCE STUDY.. COLONOSCOPY.. SURGEONS OPINION..
Colon sepsis after Appendicitomy. Needs further investigation and evaluation to conclude and line of treatment.
Post surgery secondary infection ? Colon sepsis Need further evaluation Adv : CTcE study Colonoscopy Surgeon opinion
POSSIBLY COLON. SEPSIS POSSIBLY SECONDARY TO POST. SURGERY APPENDICECTOMY /.
RECTAL CANCER I think there may be recurrence of the ca. Send the patient for the biopsy.
Ch inflamatory Bowel Disease. Crohn disease
Secondary infection post appendectomy Sepsis Need to evaluate completely
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