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Re: Interesting puzzling caseFrom: Gerald P.Rodriguez (geraldpr@cybermesa.com)Wed Aug 30 10:52:10 2006
Cholecystitis. Gerald P. RodrÃguez, M.D., FACOG Santa Fe
> ----- Original Message ----- 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 âstomach problemsâ, work-up by GI âdelayed gastric emptyingâ, 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
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