A 36-year-old female, G7P7, presents to the ER complaining of severe abdominal p
ID: 62599 • Letter: A
Question
A 36-year-old female, G7P7, presents to the ER complaining of severe abdominal pain. Her last pregnancy was five years ago. To prevent further pregnancy, she has been taking oral contraceptive pills for the past four and a half years. She is obese and physical exam is remarkable for right upper quadrant pain, negative Murphy?s sign, and jaundice. Laboratory is significant for an elevated bilirubin level. . Which ancillary test would you request to confirm your diagnosis? . What is the most likely diagnosis? . What would you advise this patient to do? . What is the pathogenesis to her condition?Explanation / Answer
May be this lady is having cholecystitis and/or gallstones. This is because she is having elevated bilirubin level. Bilirubin level elevated due to excess consumption of steroid pills.
Initially an abdominal ultrasound showing gall bladder can be done. Blood tests are done to find out infections of gall bladder in the blood. Then at CT test is also done. A HIDA scan is the exact test which scans the presence of cholecystitis.
First of all, the patient is advised to adopt fasting until the inflammation is cleared. This is so because, eating and drinking will put stress on gall bladder. And to clear the inflammation, the patient's gall bladder should get rest for a few days.
Then pain killers should be administered, so that the patient is relieved off the pain. And lastly, antibiotic treatment is given to remove the inflammation.