الجمعة، 28 نوفمبر 2008

case 10

general aspect:49 years old male with periumbilical abdominal pain ,fever and diarhoea for 5 days
no rash no ronchi no splenomegaly yet
leuckocytic count is 12600
CRP is 96 mg/L
against widal in this case is :choose
leuckocytosis
duration of symptoms
diarhoea
all of the above
after 1 weaks he developed severe epigastric tenderness and mild generalized abdominal
distention
U.S showed thrombosis of the left branch of portal vein
how to manage this case.......

هناك 4 تعليقات:

shady gad يقول...

that is not my case
thank you all

غير معرف يقول...

i think it is

spontaneous bacterial peritonitis

so,management by antibiotics

Khaled Selim يقول...

أنا مش عارف

بس هحط رد عشان أعرف أتابع الردود التانية
و أعرف الحل طبعاً


شكراً

shady gad يقول...

بسم الله الرحمن الرحيم
against widal in this case is all of the above
typhoid fever is characterized by leukopenia except GIT Hge
also widal test and antibody titre is not effective before 1 week
in typhoid fever constipation is common more than diarhoea
portal vein thrombosis in its left branch to the left lobe of liver causes epigastric pain as portal vein supplies 65_75% of hepatic blood supply .portal thrombosis is due to sepsis, dehydration, cholangitis,appendicitis ,cirrhosisand hyper coagulability .it may be sepsis in this case and itis benign and need no ttt it will re canalize without complication.abdominal distention may be due to asceites