SHORT CASE
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A 13 year old female came to OPD with complaints of abdominal pain since 2 days associated with two episodes of vomitings.
PRESENT HISTORY:
Patient was apparently asymptomatic 2 days ago then develop epigastric pain on radiating moderate severity and gradually progressive, non radiating
2 episodes of vomiting since 2 days with food as content .
PAST HISTORY :
K/C/O OF sickle cell anaemia since 9 yrs
History of sickle cell crisis 5 yrs ago
History of pancreatitis 2 yrs ago
Last blood transfusion 1 yr ago
Personal history:
Diet : mixed
Apatite : normal
Sleep : adequate
Bowel and bladder: regular
Addictions : no addictions
Genral examination :
PATIENT IS CONCIOUS , COHERENT COOPERATIVE
ICTRUS present,
PALLOR present,
No CLUBBING , CYANOSIS , LYMPHADENOPATHY, EDEMA
VITALS -
TEMPERATURE - afibrile
PULSE RATE - 90 bpm
BLOOD PRESSURE - 110/70 mm of hg
RESPIRATORY RATE - 26cpm
SPO2 - 99 % AT ROOM AIR
SYSTEMIC EXAMINATION:
CARDIOVASCULAR SYSTEM : S1 AND S2 HEARD , NO MURMURS
RESPIRATORY SYSTEM : BILATERAL AIR ENTRY PRESENT ,NORMAL VESICULAR BREATH SOUNDS
CENTRAL NERVOUS SYSTEM : NAD
P/A - diffuse tenderness present, no organomegaly
INVESTIGATIONS:
Serum lipase #570 IU/L (13- 60)
Serum creatinine #0.4 mg/dl (0.5 -1)
SERUM ELECTROLYTES
Sodium 140 mEq/L
Potassium 4.2 mEq/L
Chloride 101 mEq/L
Blood urea :46 mg/ dl(12-42)
Blood investigations:
HB #7.9 gm /dl(12-15)
Total count #16,400 cell/cumm(4000-10000)
Neutrophils 75 %(40-80)
Lymphocyte #17%(20-40)
MCHC #37.6 % (31.5 -34.5)
RBC count # 2.50 millions per cumm( 3.8-4.8)
LIVER FUNCTION TESTS
Total bilirubin #20.5qmg/dl(0-1)
Direct bilirubin #14.13mg/dl(0.0-0.2)
SGOT #170 IU/L(0-31)
SGPT #180 IU/L (0-34)
Alkaline phosphatase #566(54-369)
Serum amylase #944 IU/L ( 25-140)
Blood urea 13 mg/dl
LDH #543 IU/L (230 -460)
BLOOD GROUPING
O+VE
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