-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: LEFT upper quadrant pain From: R. Daniel Braun (rd.braun@gmail.com) Tue Feb 5 05:55:33 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Insurers Begin To Reimburse for Online Visits, Concerns Remain" Previous message: R. Daniel Braun: "Re: Insurers Begin To Reimburse for Online Visits, Concerns Remain" In reply to: Glen Elrod: "LEFT upper quadrant pain" Next in thread: Glen Elrod: "Re: LEFT upper quadrant pain" Hematology w/u for splenomegaly. Dan On Feb 4, 2008 7:24 PM, Glen Elrod <dr99645@yahoo.com> wrote: > 18 yo G1P1 delivered by another provider (lay midwife) early January. I > met her when she came to the ER with a delayed postpartum hemorrhage that I > ended up transfusing her 2 units after her D&C. > > At one of her postop/post hospital checks she mentions that she has had > left upper quadrant pain. Initially I thought it was new, but now know that > it has been there for 2 years or more. She notices it all the time to some > degree. She notes it to be worse with being up and about, better with > sitting or particularly lying down. She denies any systemic symptoms > otherwise (thinking splenomegaly and mono symptoms) > > On exam I can't palpate the spleen (would I really know it if I felt it? > probably since she is thin) and there is not much abdominal wall > tenderness. > > CBC shows thrombocytosis with plt count of 575 but nearly normal h/h and > normal indices and normal WBC. Comprehensive metabolic panel is normal. > > Today, now two weeks later and still having pain. Better exam and I do > feel the tip of the spleen and it is tender to palpation. She does have an > increase in pain over the rectus muscles when she goes from lying flat to a > sitting position. Specifically, she is tender just where the rectus and the > transversus/oblique intersect. > > Since it was there before the pregnancy, I think I can discount the > transfusion and reactive thromobcytosis as a cause. > > Does anyone else have any better suggestions other than muscle strain of 2 > year duration??? > > Thanks, > > Glen > -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 Next message: art fougner, md: "Re: Insurers Begin To Reimburse for Online Visits, Concerns Remain" Previous message: R. Daniel Braun: "Re: Insurers Begin To Reimburse for Online Visits, Concerns Remain" In reply to: Glen Elrod: "LEFT upper quadrant pain" Next in thread: Glen Elrod: "Re: LEFT upper quadrant pain"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Sat Aug 2 04:54:51 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.