A 56 yrs old Female with C/O - Pain around Umbilicus with Vomiting since 4 days TLC- 24000, HB - 13.5gm% Kindly give your Valuable Opinions regarding her further Treatment

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Agree with Dr Mrinal

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Rule out appendicitis. Rupture ovarian cyst. Any renal stoneor ureteric stone. Worms

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Pain arround umbilicus Raised TLC It is infective pathology D/d 1 subacute appendicitis 2 duodinitis 3 IBS Needs to treat conservatively and followup

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? Subacute intestinal obstruction , Suggest Plain X-ray abdomen in erect posture, CT abdomen , urinalysis , RFT ,LFT SURGICAL OPINION , Antibiotics, IV fluid support ,

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Hydronephrosis Shwadaustradi Guggulu, Varunadi Kwath, Punarnava Mandur, Punarnavashtak Kwath.. Follicular cyst tab. Hyponidd(charak) 2bd one hour after meals . scanty periods -Tab. Senovila 2bd for 3cycle, tab. Arogyavardhini vati 2bd empty stomach with luke warm water.

Pain around umbilicus with high total count may be due to needs clinical evaluation A. Acute appendicitis B. Duodinitis C IBS a. Crohn's disease B. Ulcerative colitis Clinical examination of this patient has got important role Para umbilical. Pain usually acute starts in case of appendicitis and settled in RIF also look for rigidity, muscle guarding Murphy's sign in case of duodinitis pain stats upper abdomen In IBS. Pain around umbilicus and mainly lower abdomen . Now after clinical evaluation treatment will depend upon your clinical ASSESment and diagnosis In case of appendicitis surgical intervention is required In other case Conservative with Iv infusion Antibiotiv Iv PPI Hydronephrosis is insignificant as no cause detected

Thanks Dr Bipin Behari Jain
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Duodenitis, Hydronephrosis, Need I/V broadspectrum Antibiotics, analgesic, Treat symptomatically CECT W/A may be helpful

I agree
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Pain around umbilicus with vomitings with raised TLC - most likely duodenitis considering some intra nominal gaseous shadow noted in upper abdomen. Need IV fluids, Parenteral antibiotics inj ceftriaxone 1 gm + sulbactum 500 mg B D for 7 days ., inj Pantoprazole IV and Emeset in drip . Mild hydronephrosis is insignificant- may be due to the passage of recent calculus. A CECT abdomen may be helpful

Thank you sir for your valuable opinion
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