Interesting case

KKH
S. Wichien
27/1/2011

Female, 74 y/o
HN : 54566434
Admit : 18/12/2011

.
:

Female, 74 y/o
CC : 3
PI : 3 .

1 .
. .

Female, 74 y/o

Female, 74 y/o

Female, 74 y/o
Looked distress from pain
BT 37.4 PR 96 RR 20 BP 140/80
HEENT : not pale, no jaundice, LN-ve
dry lips & tongue
Heart : normal
Lungs : normal

Female, 74 y/o
Abdomen

Distension, hypertympanic on percussion

Generalized mild tenderness
No guarding
BS : decrease
No mass

Ext : no edema
PR : empty rectum, no mass
Groin : not seen hernia

Female, 74 y/o
Hb:13.3
Hct=39.3mg%
WBC=6600
Platelet=272000
NE=58.3% LY=27.4%
BUN=35

Cr=0.9

Na=132
HCO3=24.6

K=4.4
Cl=96

Female, 74 y/o
Provisional Dx

Complete small bowel obstruction

DDx

Female, 74 y/o
Imp

Gangrenous small bowel obstruction

(adhesion band from meckel diverticulum)

Procedure

EL, segmental small bowel resection, EEA

Thank You