Re: Interesting puzzling case

From: Joe Cutchin (forcep@intercom.net)
Wed Aug 30 10:57:55 2006


Watch her like a hawk. Don't want to miss bowel injury. I would imagine by now though if she has bowel injury it would be manifesting itself with more severe symptoms. Bottom line: I would feel more comfortable examining her myself if I did the surgery. Joe C

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
>





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