Showing posts with label gallbladder. Show all posts
Showing posts with label gallbladder. Show all posts

Saturday, May 31, 2025

52M GB Abscess WB PaJR


20-01-2023

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.

PATIENT HISTORY: Patient is a 52yr old male doing business supplying small machine parts.
At the age of 12yrs, he c/o anorexia, incomplete evacuation of stool, and acidity. He was taken to a local doctor who detected hepatomegaly and prescribed medications, taking which resolved his symptoms within a few days.
At the age of 13, he c/o high fever (103-104F), headache, and general body weakness lasting for 3-4 days, resolved with medications. 2 yrs later it happened again.
In 2020, one day when he went to a function, where he ate lot of fries, chicken and sweets. After returning home at night he started c/o localised intense pain in the right upper quadrant. The pain was increasing as the night progressed and taking medication for gas did not help. The next day his pain became unbearable and got admitted in a hospital, wherein he was injected with medication to relieve the pain. His pain reduced slowly. USG was done which detected Gallstone.
He went to a doctor who did a Laparoscopic Cholecystectomy. He had no complaints after that.
In 2022 he c/o localised mild pain inupper right quadrant. Initially the pain would occur at any time of the day 1-2 times daily and would last 10-15 mins. Mostly after dinner when he went to sleep and in a supine position. On tossing and turning to either side slowly the pain would disappear after 10-15 mins. For the past few weeks the pain occured 4-5 times a week. Doctor prescribed paraetamol which reduced pain temporarily. Then USG and CT abdomen were done which revealed a liver abscess. Doctor performed USG guided Percutaneous drainage, but during a follow up, doctor told there had been not much improvement and he would need a laparoscopic drainage of liver abscess. He didn't go for any further consultation.
Patient reported for the past few months he is passing brown greasy stools.
For the past 15-20 days, he is experiencing incomplete evacuation of stools.
After being diagnosed with a liver abscess he lost 4-5 kgs of weight which he regained in the past few months.
Patient denied any history of HTN or DM.

Sunday, May 4, 2025

24F Gall Stone Pain 1st Episode 1 Week, Voice, Exam Stress Depression Years WB PaJR


03-05-2025

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.

JUNE 29, 2024

 A 24 years Female patient discussed about her mental stress problems and depression for upcoming exams. She shared that from childhood she has a fear at home, and for some reason she can't concentrate. She also shared her problem with sudden weight gain. She had broken voice due to cold once, and she took Steroids medicine, that's why she gained weight.The PHR, patient journey record PaJR transcripts below reflect the therapeutic uncertainties around the patient and their resolution through team based learning:

Thursday, May 1, 2025

62F Chronic Anasarca, Heart Failure, Post Cholecystectomy since 1 year Telangana PaJR

 


01-05-2025

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.

EMR SUMMARY

MARCH 2025

Age/Gender: 65 Years/Female

Address:

Discharge Type: Relieved

Admission Date: 03/03/2025 12:11 PM

Diagnosis

DECOMPENSATED CHRONIC LIVER DISEASE SECONDARY TO ? NAFLD WITH OESOPHAGEAL VARICES WITH PHGD

GRADE I - II HEPATIC ENCEPHALOPATHY

S/P LAP CHOLECYSTECTOMY 1.5 YEARS AGO K/C/O TYPE II DIABETES MELLITUS SINCE 10YEARS K/C/O HYPOTHYROIDISM SINCE 30YEARS

Tuesday, April 29, 2025

40F Since 1999 Gall Bladder Surgery and Recurrent Intestinal Obstruction Telangana PaJR

 


29-04-2025

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.

OPD now: Project optimizing clinical complexity in abdominal pain @PPM3 @PPM4 @SE this patient's story is similar to the one I shared about following up since 2005!
40F with problems since 1999 with pregnancy, post cesarean, gall bladder pain and lymph node issues 
1995 Marriage at the age of 12 (while studying in 7th standard, husband was in 10th)
1999: pregnancy with right hypochondrial pain and vomiting everday with weight loss till delivery by LSCS and yet pain abdomen didn't relieve. Referred to Hyderabad pvt hospital where lap cholecystectomy was done on December 1999 and she was alright till 2003 after which she noticed recurrence of pain abdomen and vomiting along with weight loss and cachexia! Went to OH in 2004 on OP basis and after one admission in 6/11/2004 to 26/11/2004 they gave up and asked her to go home and die! She went to GH and there they did an exploratory laparotomy and found a CBD structure which was rou-en-yed by joining the CBD with the jejunum. Then they also removed a lymph node from the abdomen that sent her on an oncology lymphoma wild goose chase @PPM5 
From 2005-2012 she was alright but developed similar symptoms of intermittent intestinal obstruction with pain abdomen, vomiting and abdominal distension which would last 24 hours and keep recurring every week till 2025 and she has avoided all marriage functions that involves eating!