56F Abdominal pain 2020, ileal perforation 2022, Dyspnea 2022, Lump abdomen Nov 2023 WB PaJR

 

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER 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.

56F Abdominal pain 5 years, ileal perforation 1year, Lump abdomen 1 month.

December 28, 2023

*56yr/F housewife married at the age 24yrs after 1yr she gave birth to 1daughter (1994 - lscs) yrs she gave birth to another daughter (lscs-1996) 

*After 5yrs in 2001 Tubectomy was done.

18yrsbacks (*In 2005) she was diagnosed with hypothyroidism and was on medication thyronorm since then started on 50mcg initially, later on 75mcg now currently on 62.5 mcg/OD. 

In *July 2020 she had 2 episodes of dark colored stools and pain abdomen and incomplete evacuation. 

-USG ABDOMINEN showed - multiple enlarged Retroperitoneal and mesenteric lymph nodes (? infective/inflammatory/? T. B

-Colonoscopic Biopsy taken from terminal ileum ulcer and HPE showed dense inflammatory cell infiltrate comprising predominantly lymphocytes with neutrophils, with no necrosis and granulomas to confirm T. B.) 

-mantoux test - 28mm & biopsy for gene expert negative. 

*20/8/2020 ATT was started.

*In August 2021 ie after 1yr ATT was stopped (colonoscopy was repeated After stopping ATT which showed normal study with no ulcers) pt improved symptomatically. 

After 18 months ie in MAY 2023 pt had pain abdomen and Xray showed air under diaphragm, emergency exploratory laparotomy was done i/v/o terminal ileum perforation. 

Now From NOV 2023 ie 5months after the surgery pt is again having intermittent pain abdomen, with swelling in left iliac region 

(CECT abd showing an ill defined soft tissue 

Density adherent to ant. abdominal wall s/o

? Focal omental necrosis/infarct? Focal

Omental infective lesion and umbilical hernia with omentum as content).

Original case report link👇

https://shivapalreddyrollno15.blogspot.com/2023/12/56f-abdominal-pain-5-years-ileal_28.html

59M Abdominal pain, vomiting, slurred speech, weakness, severe Hyponatremia, Toddy potomania, PaJR

 

18-12-2025

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.

[10.49 am, 19/12/2025] PPM 1: History shared by @PPM3 

C/o pain abdomen since 10 days

Loss of appetite since 10 days

Vomitings since 8 days 

Unable to walk properly since yesterday 

Slurring of speech since yesterday 

Hiccups since yesterday 

Fever since yesterday 

27F SLE Vomitings since 1 month pain abdomen since 10 days Telangana PaJR

 

09-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER 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.

DESCRIPTION:

27 year old female k/c/o SLE since 3 yrs came to the casualty with c/o vomitings since 1 month

C/O Pain Abdomen since 10 days.

Vomitings for 1 month, immediately after intake of food (for both solids and liquids) associated with nausea, pain abdomen, diffuse, sudden onset, spasmodic type, non radiating, aggravated on food intake.

H/O Fever on and off 1 month back with discoid type of skin lesions.

H/O skin lesions over ear and face 2 yrs ago with alopecia, and diagnosed as SLE based on positive anti ds DNA antibodies and ANA and patient was treated with steroids and methotrexate, HCQ since then.

3F Diarrhoea, Vomiting, Fever April 2025 (Recovered) Intermittent Abdominal Pain Days WB PaJR

 

02-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER GUARDIAN'S 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.

This is the case of a 3 yr old female child experiencing abdominal pain, vomiting, diarrhoea and fever for 5 days since the last week of April. Following this she was hospitalised and some tests were done. Which revealed a CRP (C-Reactive Protein) level of 300+ and was diagnosed with colitis.

After seven days of treatment, she became normal. However for the last 10 days she has been experiencing mild abdominal pain at night.

61F GAD DM2 2018 WB PaJR

 

OCTOBER 15, 2022

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER 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.

PATIENT HISTORY

Patient is a 61-yr old female, homemaker.

First pregnancy in 1985 (normal delivery) uneventful.

In 1990 the patient noticed white discharge during menstruation along with menstrual bleeding (normal, no pain). Doctor diagnosed it to be a uterine tumor and Sx done. Soon after she got pregnant, but her menstrual cycles did not stop, bleeding for 1 day per cycle, with no discharge. After six months into the pregnancy, doctor reported fetus had died and was aborted.

In 1993, got pregnanat for the 3rd time. This time also menstrual cycles did not stop. Bleeding for one day only per cycle and had normal delivery.

In 2005 due to continuous extreme abdomen pain, went to doctor who diagnosed it to be due to uterine cysts. Hysterectomy and bilateral salpingo-oophorectomy were done.

In 2009 February, patient fell down from ladder almost 10ft and #L1 vertebra. Recovery with medicine, bed rest and physiotherapy.

In 2010, c/o severe epigastric and hypogastric pain and agitation. Endoscopy and colonoscopy done. Medicine prescribed (Rabeprazole 20 mg, Levosulpiride, Omeprazole {continued till 2013, then since 2021 till date})

Since 2011 Jan, started Clonazepam 0.5mg , because at that time her husband had recently died and her daughter was still unmarried. Now, takes only when she c/o trouble sleeping or anxiety. Takes 2-3 times per month. 

In 2015, c/o continuous lower back pain and elbow pain lat epicondyle (?tennis elbow). Dr advised wearing a belt again (which provides relief) for back pain and gave injections(?steroid) in painful area of elbow, which resolved elbow pain. 

In 2016, while on a follow-up for the abdomen pain a lot of tests were done. TSH lvl was 6 mlU/L. Did not prescribe any medications.

In 2017 May, due to a persistent high fever she was asked to do blood and urine tests which detected UTI and her TSH lvl was 8 mlU/L. Medicine Thyronorm 50 was prescribed.

In 2018, for 3 months c/o itchy red rash in the thigh and above elbow jt. Resolved with medicines and ointment. Around that time on a separate occasion c/o persistent fever, for which blood tests were done. DM was detected. Medicine prescribed Glycomate 500 SR.

In 2018, she c/o headache, dizziness, nausea and weakness in getting up from bed. After 1 month, she was taken to a Dr. who did an cervical X ray (report not available) and prescribed medications, taking which she recovered within days. Thinking the headache was due to eye problem she was also taken to Opthalmologist that time.

In 2020, again c/o abd pain in epigastric and hypogastric regions. Colonoscopy and endoscopy done. Erosive gastritis with gastric polyps were detected of which 2 polyps were removed later on 2021 via endoscopic polydectomy. Colonoscopy detected small internal piles.

While on a regular checkup for DM, Dr. prescribed he to take 

 For the past one month, c/o lower abd. pain, heartburn, throat burning constipation. Dr diagnosed it to be IBS. Prescribed medicine for 3 wks, taking which reduced her symptoms to certain extent.

Pt is diabetic and on medication. 

Addiction of eating Paan 3-4 times per day for the past 20 days.