Case (46)

[dr-awale]

49-year-old woman presented to our emergency department
at noon because of abdominal pain that
awoke her at 5 AM. She described feeling full; however, she
was able to expel flatus. Throughout the morning, the
abdominal pain gradually worsened. She had cramping,
intermittent, and diffuse pain in the upper and lower abdominal
areas bilaterally. The pain was associated with
nausea but no vomiting. She had undergone total abdominal
hysterectomy and bilateral salpingo-oophorectomy 6
months previously because of uterine fibroids that caused
menorrhagia.
The initial examination revealed an anxious woman
with a diffusely tender nondistended abdomen. Bowel
sounds were normal, and no peritoneal signs were present.
Findings on a rectal examination were normal, and there
was no impacted stool. A subsequent evaluation included
decubitus and upright x-ray films of the abdomen, findings
of which were interpreted as showing an increased amount
of stool in both the small and the large bowel but otherwise
normal. Blood studies showed mild leukocytosis with a
leukocyte count of 11.1 × 109/L (neutrophils, 90.8%;
monocytes, 2.0%; lymphocytes, 6.6%; basophils, 0%; and
eosinophils, 0%). The levels of serum electrolytes and
amylase were within the reference range.
1.what is the most likely diagnosis?
2.what treatment you give this patient?
3. make differential diagnosis?

[Viza]

asc, thank you dr-awale for you're good question.
if i try you're question answer:

1.what is the most likely diagnosis?
chlecyctitis
2.what treatment you give this patient?
intravenous hydration with normal saline.
3. make differential diagnosis?
acute diverticulitis,small bowel obstruction, crohn's disease, and ulcerative colitis.
thank you dr

[dr-awale]

asc
thank u noone the greet expert laboritist for ure answer
u get 15 mark allah yubarik ya akhi.