Transcript Slide 1

 ID
 CC
: 71 years old female
: Abdominal Pain
71 years old female
Abdominal pain
Periumbilical
Colic
Without radiation
Not related to the patient’s position
Anorexia
Last defecation: 2 days ago
Gas passage : +
Vomiting :
Not bloody
Non biliary
Contained food remnant
No abdominal distention
No urinary symptoms
No history of fever
Drug history : Negative
Past medical history:
History of an umbilical hernia from several
years ago
Family history: Negative
Old female, lying on the bed, toxic but not ill
BP: 120/75 PR: 84
T: 36.8
RR: 16
Conjunctiva was pale, sclera was not ichteric, JVP
was not distended
S4 was auscultated in heart examination
lungs were normal in auscultation
Abdominal examination :
No distention
Bulging could be seen in the umbilical area
with out erythema
Bowel sounds were hypoactive
Generalized tenderness, more severe in the
umbilical area
No guarding
TR: Not bloody, No tenderness, Empty ampula
CBC:
Hb: 13.9 WBC: 5800 (73% Neutr) Plt:242000
Na: 138 K: 4 BS: 97 Urea: 37.6 Cr: 0.6
Amylase: 66.7
U/A:
PH: 6 color: yellow Appearance: Clear
WBC: 2-3 RBC: 2-3 EP: 1-2