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Re: Interesting puzzling case From: Andrew Folley (agfolley@hotmail.com) Wed Aug 30 18:06:39 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ronald Ainsworth: "Re: Ob: When to do a first" Previous message: Garry E. Siegel, M.D.: "Ob: When to do a first" In reply to: Gerald P.Rodriguez: "Re: Interesting puzzling case" Next in thread: Joe Cutchin: "Re: Interesting puzzling case" With a wbc of 19000 two weeks post op and all other clinical findings normal ie vital signs and abdominal exam, I am thinking that something is walled off in the RUQ although I like Lynns thinking of wathcing our for a PE as well. She needs observation 24 hours. No antibiotics serial CBC and chest Xray and CAT of the abdomen. Unusual for a ureteral obstruction to present this way but needs to be in our differential. >From: "Gerald P.Rodriguez" <geraldpr@cybermesa.com> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: Interesting puzzling case >Date: Wed, 30 Aug 2006 10:53:32 -0500 > >Cholecystitis. > >Gerald P. Rodríguez, M.D., FACOG >Santa Fe >> ----- Original Message ----- > From: ENDODOK@aol.com > To: Multiple recipients of list OB-GYN-L > Sent: Wednesday, August 30, 2006 9:06 AM > 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: Ronald Ainsworth: "Re: Ob: When to do a first" Previous message: Garry E. Siegel, M.D.: "Ob: When to do a first" In reply to: Gerald P.Rodriguez: "Re: Interesting puzzling case" Next in thread: Joe Cutchin: "Re: Interesting puzzling case"

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