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👇
