Author Topic: Clinical case presentation  (Read 26454 times)

0 Members and 1 Guest are viewing this topic.

Offline Soomaali

  • Newbie
  • *
  • Posts: 3
  • Points: +0/-0
  • Gender: Male
Clinical case presentation
« on: November 27, 2009, 11:05:53 AM »
Lower Abdominal Pain in a 30-Year-Old Woman

A 30-year-old woman with no significant past medical history presents to the emergency department (ED) with intermittent nonradiating pain in the lower-left part of her abdomen. The pain started approximately 5 days ago and has been steadily worsening since then. She has also been experiencing fevers. At presentation, the patient describes the pain as "severe" and notes that it increases with any motion. There have been no abnormal urinary symptoms (ie, pain during urination or increased frequency of urination). Additionally, she has not had any changes in her bowel habits, including no constipation or diarrhea. She is married and monogamous, and her last sexual intercourse was 2 weeks ago. She has regular menses, with her last menstrual period occurring approximately 3 weeks ago. There is no vaginal discharge. She has no history of any sexually transmitted diseases. She does not smoke and does not use any illicit substances.

On physical examination, the patient has a temperature of 100.2°F (37.9°C) and a blood pressure of 116/63 mm Hg. The patient is tachycardic at about 120 bpm, but seems to have a regular rhythm. Her respiratory rate is normal at 10 breaths/min. She is clearly uncomfortable but does not appear to be toxic. Except for the noted tachycardia, the cardiac and respiratory examinations are unremarkable. The abdominal examination reveals tenderness in the lower abdomen, specifically in the left lower quadrant, but no rebound or guarding is noted. A pelvic examination is performed that reveals scant blood in the vagina and cervical motion tenderness. An 8-cm mass is palpated in the left adnexa, with marked tenderness. The uterus is tender and normal in size. The right adnexa is tender, but no palpable masses are detected.

Initial laboratory investigations are ordered. A complete blood cell (CBC) count reveals an elevated white blood cell (WBC) count of 13.5 × 103/µL (13.5 × 109/L), a normal hematocrit of 38% (0.38), and platelets of 256 × 103/µL (256 × 109/L). A basic chemistry panel and a coagulation profile are unremarkable. A urine test for beta–human chorionic gonadotropin (beta-HCG) is negative, and the urine analysis is negative for evidence of a urinary tract infection.

Transvaginal and transabdominal pelvic ultrasonography are performed
What is the diagnosis?
Hint: Observe the abnormality in the left adnexa
1.Tuboovarian abscess
2.Ovarian cyst
3.Ovarian torsion
4.Appendicitis
Thanks alot



Prevention is better than treatment


Offline Anotherabdi

  • Newbie
  • *
  • Posts: 12
  • Points: +0/-0
  • Gender: Male
Re: Clinical case presentation
« Reply #1 on: September 20, 2010, 08:02:13 AM »
look out for this prompt answer (seems like no one uses this forum).
sounds like tubo-ovarian Abscess: because of left quadrant abdominal pain (appendicitis less likely), fever (ovarian cyst, torsion less likely), palpable masses on the left ovaries. negative beta-HCG (ectopic pregnancy less likely), monogamous, no vaginal discharge, no STD history (PID less likely), normal UA (UTI less likely)
1.Tuboovarian abscess
2.Ovarian cyst
3.Ovarian torsion
4.Appendicitis


 

New Case with "Foreign Accent syndrome"

Started by AdminBoard Health News and Events

Replies: 4
Views: 41433
Last post May 07, 2011, 09:55:27 PM
by drishak
Lifestyle choices may help treat mild case of obstructive sleep apnea

Started by Ahmed_07Board Topics in Healthcare

Replies: 0
Views: 43458
Last post December 29, 2013, 03:50:19 PM
by Ahmed_07
Malaria Case Management Coordinator - Horn of Africa (MENTOR)

Started by AdminBoard Medical Jobs & Trainings

Replies: 0
Views: 32691
Last post August 09, 2011, 09:01:01 PM
by Admin
Patients may mislead you to appraoch the diagnosis! True Case

Started by SOYDABoard Humanitarian Aid Organizations

Replies: 4
Views: 39850
Last post April 10, 2008, 02:20:54 PM
by Waxbaro!
Vacancy: Bi-Lingual Case Manager (Somali-English)

Started by AdminBoard Medical Jobs & Trainings

Replies: 0
Views: 33248
Last post October 31, 2010, 08:22:25 PM
by Admin