|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Puzzler?? 24 week ob with severe left flank painFrom: ATFSOCCER@aol.comSun Aug 24 23:26:15 1997
Sounds routine enough but it was not. 27 yo bf presents at 24 weeks with very painful left CVA area. Sent out of office with working dx of stone after microscopic hematuria noted and given antibiotics and analgesics. Presents to hospital 48 hrs. later with severe flank pain, fever 101 and wbc of 15000 and hematuria with pain excerbated with inspiration. Received IV Ancef for 72 hours and she defervesced after the first 24 hrs. Working dx of probable pyelonephritis. Obtained an IVP which was negative. Sent home on Monday with oral antibiotics feeling much better and pain present but tolerable. Returns Thursday night to hospital writhing with left CVA pain and somewhat dyspneic no fever wbc again 15ooo. Nothing grew out on C&S Pain controlled with IV demerol. Put her through more extensive workup at this point with CHEST XRAY negative, US negative of kidneys, ureters fetus and placenta, blood gasses normal with PO2 80. Out of concern for possible PE I still ordered a V/Q scan which was normal. My last thought is for a possible ovarian vein thrombosis??? No history of trauma, she has sickle trait but not disease, no obvious OB problems. I am hoping a CAT scan may shed some light or at least help exclude a few other etiologies in the diagnosis. (adrenal cyst? subluxed thoracic disc with pinched nerve??) What else can you think of?? (Tine test negative) Thanks for any input, suggestions or shared experiences.
|
|
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: Mon Nov 2 05:23:15 2009 |
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.