Severe Pain in Lower Right Quadrant Abdomen

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Abdominal Pain

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Medical Quiz

Interactives

Ask Queries

SPECIALIST ANSWERS

Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

Video Podcast

Videos in Medicines

Medical Training Videos

Clinical Video Resource

Videos on Asthma

Audio Cast

Lecture on Pediatrics

Medical Training Audios

Clinical Audio Resources

Audios on Asthma

Mobile (wap)

Staying connected to Pediatric Oncall is now easier with Pediatric Oncall Mobile . You can now download selected content from the latest issue of Pediatric Oncall.

Research Grant

FIND DIAGNOSIS

VACCINE REMINDER

Get the Vaccine Schedule for your child."

	Specialist Answers
Question
CASE: This is an 18 year old female who presents to the emergency department with severe pain in her lower right quadrant abdomen for the past two weeks. She describes the pain as sharp and worse than being stabbed by a knife. She shows prior history of fever and chills. There is some suggestion of urgency, but no dysuria. She feels nauseous and but has not vomited. Her LMP was four weeks ago and she denies any possibility of pregnancy. Her past medical history is unremarkable. There is no family history of kidney stones. Examination: VS T36.7 (oral), P89, R 20, BP 90/60, oxygen saturation in room air 99%. She is alert and cooperative. She is uncomfortable, but she does not appear to be in severe pain. HEENT unremarkable. Neck supple. Heart rate is regular without murmur. Lungs are clear. No chest tenderness is seen. Her abdomen is soft and non-tender on palpation. Bowel sounds are normoactive. There is no rebound tenderness. Her abdomen is tender over in the right upper quadrant. Her distal pulse are good. She is able to move all her extremities well and she speaks well. Blood studies are drawn and an IV is started. Her urine pregnancy test is negative and she is sent to radiology for an abdominal series. Radiology Investigations Results 1.Blood tests: CBC, metabolic profile all are within normal limits 2.Plain X-Ray abdomen: Mass of faeces in the RUQ, preliminary diagnosis constipation. Patient is given laxatives both oral and enema. Second x-ray reveals no obstruction. One week later patient still has RUQ pain, but x-ray is clear. 3.Abdominal Ultrasound: No clinical evidences, all organs are healthy. Question: Any differential diagnosis?
Answer
Rule out appendicitis, pelvic inflammatory disease, porphyria, hepatitis. Her Blood pressure is low (90/60). Rule out septicemia. A urine test for urine infection should be ruled out. Back to All Questions

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Head circumference Calculator

Mid parental height Calculator

Body surface area Calculator

BMR Calculator

Temperature Calculator

Anion gap Calculator

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids