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Re: Interesting puzzling case From: Rafael Haciski (haciski@earthlink.net) Wed Aug 30 22:52:13 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Interesting puzzling case" Previous message: Garry E. Siegel, M.D.: "Re: Ob: When to do a first" In reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Efrain Ramirez: "Re: Interesting puzzling case" That indeed is a tough one. I would bring her in, see her personally, admit for observation, cultures, serial WBCs, appropriate consults, and CT scan. Treat whatever you find, if nothing found, and continued sick clinically, laparoscopic detailed evaluation of the entire pelvic and abdominal cavities. -- Rafael Haciski MD FACOG Palmetto, FL On Aug 30, 2006, at 11:07 AM, ENDODOK@aol.com wrote: > 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: Efrain Ramirez: "Re: Interesting puzzling case" Previous message: Garry E. Siegel, M.D.: "Re: Ob: When to do a first" In reply to: ENDODOK@aol.com: "Interesting puzzling case" Next in thread: Efrain Ramirez: "Re: Interesting puzzling case"

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