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Re: Interesting puzzling case From: DoctorJoe@aol.com Wed Aug 30 10:32:07 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Lynn Montgomery, MD: "Re: Interesting puzzling case" Previous message: art fougner, md: "Re: Interesting puzzling case" Maybe in reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Lynn Montgomery, MD: "Re: Interesting puzzling case" In a message dated 8/30/2006 10:07:50 A.M. Central Standard Time, ENDODOK@aol.com writes: 39 yr old G2P2 (C/Sx2) underwent simple LSH for adenomyosis, discharged 4 hrs.post-op. Recuperation rapid. Awoke 2AM p.o. day 14, with epigastric and RUQ pain, and 2 diarrheal stools. No chills/ fever/ anorexia/, nausea or vomiting. Pt has very long Hx. of “stomach problems”, work-up by GI “delayed gastric emptying”, Rx with Reglan and Zantac. Sx. occur a couple of times per year, slow response to above meds. Pt. lives 35 miles away, went to her local community hospital that evening as pain increasing. P/E totally negative- Vitals normal, abdomen soft, non-tender, no distention, no guarding, no rebound, BS wnl. Pelvic unremarkable- no mass/ induration / tenderness/ local heat ( as one can find with a hot TOA). Hct 40%, WBC 19,000. Your thoughts?? Antibiotics given? There ARE reports of colitis after only one dose of perioperative prophylactic antibiotics. Alternatively, the RUQ is where "stuff" drains/swims, so she could be developing post-op infection. However, with normal PE that would be down the list. Then there's also perioperative drug related hepatitis. Joe P. Next message: Lynn Montgomery, MD: "Re: Interesting puzzling case" Previous message: art fougner, md: "Re: Interesting puzzling case" Maybe in reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Lynn Montgomery, MD: "Re: Interesting puzzling case"

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