Acute GE

AMC 

Bed no- 3

A 40yr old female patient resident of dhandampally came to the casualty with 

c/o pain abdomen since 2days , vomitings and loose stools since 1day .

HOPI - 

Patient was apparently asymptomatic 2days back 

Then she had 

Pain in lower abdomen which is colicky in nature , initially radiating from loin to groin , presently non radiating pain confirmed to lower abdomen .

Vomitings -10 episodes since 1day , non bilious , non projectile , food as content .

Loose stools - 4episodes since yesterday night .

No H/o fever , cough , burning micturition.

H/o intestinal obstruction 5yrs ago , exploratory laprotomy and adhesiolysis done .

Hernioplasty 15yrs back 

Hysterectomy 15yrs back 

LSCS -21 yrs back 

Not a k/c/o HTN , DM,TB, Asthma , CAD, CVD 

Personal history -

Diet - mixed

Appetite - normal

Bowel & bladder movements - regular 

No addictions

Family history - not significant

On Examination 

patient is c/c/c

No pallor , icterus , cyanosis , clubbing lymphadenopathy ,  edema

Vitals -

Temp - Afebrile 

PR - 105bpm

BP - 100/70 mmHg

RR -14cpm

SpO2- 98%@RA

Systemic examination -

CVS - S1 S2 +VE 

RS -BAE +VE , NVBS +VE 

P/A - soft , non tender , BS +ve 

CNS - NAD 

 

Investigations

Provisional diagnosis - 

Acute GE

Treatment -

IVF 500ml NS Bolus ,UO+ 30 ml

INJ PANTOP 40MG/IV/OD

INJ ZOFER 4MG /IV /OD

INJ METROGYL 100ml /IV/TID 

TAB SPOROLAC PO/TID 

ORS SACHETS 1 IN 200ML OF WATER (100ml /stool)

INJ BUSCOPAN 2CC IV STAT

INJ TRAMADOL 1AMP IN 100ML NS