Case
sub-acute peritonitis

Age: 46
Sex: Female
Race: Igbo Nigerian

History
History of present illness:
Four days history of fever, abdominal pain, diarrhoea and vomiting followed by 3-days of constipation.

Medical History:
Nothing significant

Past surgical history:
Nil

Allergies:
Nil

Medications:
IV fluids and antibiotics

Family history:
Nil

Social history:
Habits in a thphoid endemic area.


Physical Exam
General:
Weak, pale and dehyrated. No pyrexia or jaundice. Tachycardia, tachypnoea and absent bowel sounds.

Temperature:
37.0 C

Heart rate:
102/min

Blood pressure:
130/80mmHg

Respiratory rate:
26/min

Oxygen saturation:
Not assessed

Head, ears, eyes, nose & throat:
NAD

Neck:
NAD

Chest:
Stony dullness and reduced breath sounds L lower zone.

Cardiovascular:
NAD

Abdomen:
Full, tender hepatomegaly, splenomegaly 3 cm, ascites present, absent bowel sounds.

GU:
NAD

Rectal:
Rectum contained formed faeces.

Neurological:
NAD

Skin:
NAD

Laboratories:
Potassium 3.4mmol/L, Urea 12mmol/L in a background of dehydration. Haematocrit 15%.

Radiology:
Left basal pleural effusion.

Other:
Results awaited

Pathology:
Awaited

Problems:
Paralytic ileus, ascites, hepatomegaly

Assessment:
Your comment

Plan of treatment:
Pending further investigations

Results of treatment:
So far patients is stable. Bowel motion resumed after rehydration and K therapy.

Discussion:
Your opinion

Pearls:
??




Comments
The following are comments made by other users of this site and are not in any way an opinion of thirdspace.org or its staff.


Bisho815/5/2006 - 1:33:54 AM
good

drolusolaadeyemi12/3/2007 - 3:38:52 AM
hi doc
the patient happens to be my fellow countrymen typhoid endemicity in uor area is common among rural duelers than urban duelers


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