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Re: Interesting puzzling case From: Lynn Montgomery, MD (apgar10@qwest.net) Wed Aug 30 10:37:08 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gerald P.Rodriguez: "Re: Interesting puzzling case" Previous message: DoctorJoe@aol.com: "Re: Interesting puzzling case" In reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Gerald P.Rodriguez: "Re: Interesting puzzling case" Don't forget the possibility of pulmonary embolus. I have seen several over the years that presented with epigastric/RUQ pain. Lynn -- Lynn D. Montgomery, M.D. Obstetrics & Gynecology, Maternal-Fetal Medicine The Birth Center/Rocky Mountain Women's Health 1211 S. Reserve St. Missoula, Montana, 59801 406-549-0978 fax 406-549-0987 e-mail: apgar10@qwest.net _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of ENDODOK@aol.com Sent: Wednesday, August 30, 2006 9:08 AM To: Multiple recipients of list OB-GYN-L Subject: Interesting puzzling case Interesting puzzling case: 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?? Glenn Bradley MD Next message: Gerald P.Rodriguez: "Re: Interesting puzzling case" Previous message: DoctorJoe@aol.com: "Re: Interesting puzzling case" In reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Gerald P.Rodriguez: "Re: Interesting puzzling case"

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