16/M WITH C/O ABDOMINAL PAIN AND VOMITINGS.
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Here is a case I have seen
Unit 6:
Case admitted in ICU on 30/1/2021.
Interns
K. Nikhil reddy
M. Swarna
K. Divya
B.Manivarma
Juveria
Dr. Vinay(pgy1)
Dr. Rashmitha(pgy2)
Dr. A. Vaishnavi (pgy2)
Dr. Sai Radha(pgy3)
Dr. Hareen (SR)
Dr.Praveen Naik( asst.prpff)
Dr.Rakeah Biswas (HOD)
Here is the case we have seen.
A 16 year old male student, resident of Ramannapet, came to casuality with Chief complaints of abdominal pain since 4 days,
vomitings since 3 days.
H/o present illness:
Patient was apparently asymptomatic 25 days back, later he had C/o vomitings 25 days back,2 episodes followed by severe sweating ,for which he went to local hospital and relieved on medication.
15 days back, he had 2 episodes of fever spikes, high grade, associated with headache ,not associated with vomiting, relieved on medication.
5 days back , he complaints of fever, low grade, associated with chills, on and off,subsided with medication.
Now, he complaints of severe pain in epigastric region, mild pain in right and left hypochondriall region since 4 days, aggrevated on lying in lateral position, no relieving factors and vomitings since 3 days ,3 episodes,associated with food particles, non bilious , not associated with blood.
No complaints of cold, cough.
No complaints of chest pain, palpitations, syncopal attacks, shortness of breath, orthopnea,PND.
No complaints of burning micturition, constipation, diarrhoea.
No known allergies
No significant family history.
O/E:
Patient is conscious, coherent,cooperative.
Icterus +
No pallor, cyanosis, clubbing , lymphadenopathy,pedal edema.
Temp: afebrile
Bp:140/70 mmhg
PR: 68 bpm
RR:22cpm
GRBS:121mg/dl.
Spo2:98% at room air
Systematic examination:
P/A: soft, tenderness noted in epigastric and left and right hypochondrium.
RS: BAE +,NVBS +
CVS: S1,S2 heard ,no murmurs
CNS: HMF +, No abnormality detected.
Clinical images:
Investigations:
SEROLOGY
FEVER CHARTING
CHEST X RAY
USG-ABDOMEN on 30/12/2021
USG ABDOMEN on 1/2/2021
Diagnosis: ACUTE CHOLECYSTITIS WITH ?CHOLANGITIS WITH DENOVO DIAGNOSED HBsAg+
TREATMENT GIVEN:
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