A 28 yearl old male with abdomen pain and vomitings.

CBBLE UDHC SIMILAR CASES 


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A 28 year old male came to casuality with C/O pain abdomen since 2 days and vomitings since 2 days.

HOPI:
Patient was apparently asymptomatic 2 days ago then he developed pain in epigastric region which was colichy type, radiating to back, no aggravating and relieving factors.

2 episodes of vomitings since 2 days, non projectile, contains food, non bilious.

No h/o loose stools, constipation, fever.
No h/o trauma.
H/O ? Endoscopy 8 years ago.

N/K/C/O DM, HTN, CAD, ASTHMA.

VITALS :
TEMPERATURE - 98.1
PULSE RATE - 127 BPM
BLOOD PRESSURE - 110/70 MM OF HG 
RESPIRATORY RATE - 16
SPO2 - 95 % AT ROOM AIR


General examination:
Patient is conscious, coherent and cooperative, well oriented to time, place and person
No pallor, Ictrus, cyanosis, clubbing, lymphoadenopathy.

Systemic examination:
PER ABDOMEN : 
-Scaphoid.
-No scars.
-Tenderness in epigastrium.
-No guarding.
-Bowel sounds heard.
CARDIOVASCULAR SYSTEM : S1 AND S2 HEARD , NO MURMURS
RESPIRATORY SYSTEM : BILATERAL AIR ENTRY PRESENT, NVBS +
CENTRAL NERVOUS SYSTEM : NAD           

Investigations:

HEMOGRAM
HB 16.3
TC 17,100
PLT 3.38
MCV 82.5
PCV 46
MCH 29.2
MCHC 35.4
SMEAR - NORMOCYTIC NORMOCHROMIC

BGT- O positive
RBS- 124


RFT
Urea 50
Creatinine 0.9
S. Sodium  140
S. Potassium  3.8
S. Chloride 98

S. Amylase 124
S. Lipase 528

LFT
TB 1.38
DB 0.45
AST 36
ALT 21
ALP 117
TP 6.7
ALB 3.73

SEROLOGY: NEGATIVE

XRAY 


ULTRASOUND
ECG
29/3/22


30/3/22



DIAGNOSIS:
ACUTE PANCREATITIS SECONDARY TO GALL STONES.

TREATMENT:
1. Inj. Tramadol in 100ml NS/IV/STAT       

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