khalid22
Forum Newbie
Topics: 3
Posts: 7
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male with 35 years old
co:1.intermittent fever
2.pain in the rt hypo condrium
3.nausea and vomitting
all for 4 days
pt had a history of irretable bowel syndrom 6 yrs ago
oe there is tender enlarged liver an jaundice
invetigation that done
hb 65%
leuckocytes 20000
esr is raised
what the diff dignosis and how to confirm each one +managemnt
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| miky
Forum Senior
Topics: 16
Posts: 99
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male with 35 years old
co:1.intermittent fever
2.pain in the rt hypo condrium
3.nausea and vomitting
all for 4 days
pt had a history of irretable bowel syndrom 6 yrs ago
oe there is tender enlarged liver an jaundice
invetigation that done
hb 65%
leuckocytes 20000
esr is raised
what the diff dignosis and how to confirm each one +managemnt
[/u][/b]
although not clearly written, this case is quite easy:
intermittent fever, pain in the RH, N&V- seems liver or gallbladder involved.
tender enlarged liver = congestive hmegaly
jaundice - obtruction?
increased ESR & leukocytes count - infection?
Hb 65 % (what's that?)
acute cholangytis (Charcot's triad) - often a stone
acute cholecystitis
liver abscess (less likely)
anyway, here's an investigational plan:
1st: abd U/S - next: cholangiography (oral / ERCP) - if gallbladder not visualized - next: HIDA scan
what's your answer? :roll:
___________________
always happy and ready to serve and help my friends and patients as well.
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