Wednesday, April 16, 2025

63M Left Hypochondriac Pain Blood in Stools Hemothorax Telangana PaJR

 



13-04-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.


[13-04-2025 20:28] PPM 3: C/o pain at the left hypochondrium since 17 days

C/o fever since 15 days

Pt was apparently normal 20 days then after a traumatic psychological event (death of a relative) patient consumed alcohol and slipped and fell, on the left side, no loss of consciousness, got up by himself and went home. He was apparently fine for 3 days, then suddenly he developed pain at the left hypochondrium, non radiating, stabbing type, not relieved by rest and also developed fever, high grade, intermittent, 2 episodes one at morning, one at evening, subsided by medication. He visited a local hospital, then on the 5th day he went to a different hospital. Because he had 1 episode of blood stained stool, watery in consistency, no h/o vomitings or nausea and was also having pain at the left hypochondrium and fever again, and shortness of breath, sudden onset, grade-2, resolved. After two days h/o burning micutrition where they found he had a 9 rib#,? Minimal hemothorax and raised urea and creatinine levels 

Past history:

N/c/o DM, HTN, CVA, CAD, TB, Epilepsy, Thyroid disorder 

Personal history:

Appetite normal

Mixed diet

Intermittent burning micutrition 

No known allergies 

Occasional alcohol consumer (90 ml once in a month)

No significant family history 

Pt was conscious, coherent, cooperative 

Mild pallor

Icterus (+)

No Icterus, Cyanosis, Clubbing, lymphadenopathy, Edema

Temp:98.6°F

Pr:80b/min

Bp:140/90 mmHg

Spo2:93% on RA

Grbs:200 mg/dl

 P/A: Soft, tenderness present at the left lumbar region

 Liver function tests 

Total bilirubin:2.88

Direct bilirubin:1.81

Ast:24

Alt:58

Total proteins:5.2

Albumin:2.5

A/G ratio:0.95

06-04-2025

















[13-04-2025 20:30] PPM 3: 8/4/25

[13-04-2025 20:30] PPM 3: Yes, they have told that the splenorenal space collection is connecting with the cyst in kidney.

[16-04-2025 15.45] PPM 1: Update: Getting discharged today

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