Procto-Colitis Case Study

After extubation, the patient endured acute delirium. The attempt to control agitation using ativan, haldol, and thorazine was not successful. Consequentially, dexmedetomidine was used to sedate the patient. Seroquel was started and dexmedetomidine was in the process of weaning off when he developed a fever to 102.7 degree Fahrenheit (°F), worsening acute kidney injury (AKI), leukosytosis, hypotension on post-operative day (POD) five. He underwent CTA chest and Computed tomography (CT) of the abdomen and pelvis with and without contrast which revealed cecal and ascending colon pneumatosis. IC was suspected. Since Mr. S was sedated, assessing for symptoms of IC were not possible. However, he had three bowel movements (BM) on POD four and one BM on POD five without melena or hematochezia.

I really enjoyed reading your response to DQ and how well you discribe Crohn and ulcerative colititis. I also wrote similar discription but I includded the part about family history of having ulcerative colititis and especially from a Jewish descent. Both of these diseases similar symptoms so mecidcal evaluation would have to be done to get the right diagnoses. Crohn disease is also associated with smoking and it is silently increase in women than

The patient you are evaluating is a 28-year-old male experiencing lower abdominal discomfort and frequent diarrhea (more than 15 bowel movements per day). He reports he has previously experienced episodes of loose stools but it seems to be getting worse. He also reports having lost 15 pounds in the past month. Both of ulcerative colitis and Crohn's Disease have many but because The colonoscopy reveals inflammation in the rectum, sigmoid colon, ascending colon, and ileum. ulcerative colitis is the chronic inflammation of the large intestine or colon. Crohn's disease commonly affects the area where the small intestine (ileum) joins the colon. Also, the symptoms of Crohn's include diarrhea that occurs for more than 6 weeks, abdominal pain and

This patient would need to be hospitalized for immediate, aggressive management with antibiotics and corticosteroids (Domingo & Barquet,

Colonoscopy lead to the discovery of diverticula in the colon. It is suspected that they ruptured and lead to on and off, self-resolving gastrointestinal bleed. Which would account for the patient’s dark stools, decreased H&H, nausea, and weakness.

A female patient aged thirty-one years old was admitted to a surgical ward with a 48 hour history of emesis and abdominal pain in an unspecified quadrant. There was no account registered regarding the possible existence of headaches, blurred vision, loss of consciousness or change in bowel habit. Her arterial blood pressure was measured at 110/65 mmHG and her pulse 88 beats per minute and regular. A provisional diagnosis of intestinal obstruction was originally made, however upon later reviewing the patients background, it was ascertained that she had a history of both weight loss and anorexia, hyperpigmentation of the skin was also observed, which is more suggestive of a primary adrenal insufficiency. The patient was managed overnight with the intravenous administration of 1500 ml of 0.9 per cent saline, and by the following morn her manifestations had resolved.

A 61 year old man was taken to his doctor after complaining of an altered bowel habit over the last four-five months, he suffered from constipation and diarrhoea, and recently had noted significant blood in his stools. Upon examination, he was found to be pale and the doctor thought he could feel a mass in his rectum. A blood test confirmed that he was anaemic. He was referred for urgent surgical examination and the surgeon confirmed the presence of a rectal lesion approximately 7 cm from the anal margin. No other lesions were found in the sigmoid colon or the rectum. A barium enema was performed to examine the entire length of the large bowel for other lesions. None were apparent. The tumour and adjacent bowel were removed by surgery. Histopathological

A 42-year-old male with history of Crohn's colitis as well as symptomatic hidradenitis. He was last seen in 03/2016. Patient last had a colonoscopy in 08/2015 at Duke. Most recently, the patient is undergoing dermatological evaluation at UNC Chapel Hill for his inguinal hidradenitis. He is on IV Remicade. The patient denies any diarrhea or bleeding. Nursing reports to me that he does have an unexplained fever that is being worked up.

Survival rate and body weight were two index during the evaluation of the severity of colitis [19, 20]. The survival rate and body weight was recorded daily during the administration of TCA.

A UC can be easily induced in animals by administering either the chemicals or bacterial infection. [46]. An ideal experimental model should mimic human UC quite closely, simple to induce, cheap and highly reproducible. Unfortunately, human UC is so complex that there is no single model that fully imitates it [46] but every model of colitis contributes valuable observations into one or another major aspect of the disease, and together they have provoked the formation of now a generally accepted set of the principle of human UC pathogenesis [59]. Amongst that different causes of induced or genetically based inflammation give rise to a limited number of common pathways of immunopathogenesis; normal resident gut microbiota can lead to an intestinal inflammation; loss of oral tolerance and alteration of the epithelial barrier contribute to the development of intestinal inflammation; and polarized T helper cell responses, as well as defects in innate immunity, mediate disease [12].

The patient is a 50-year-old gentleman with a medical history of cerebral palsy, seizure disorder, and multiple admissions for fecal impaction who was brought to the emergency with severe abdominal pain. The patient is nonverbal and does not follow commands. The family and the chart reveals the patient has been pointing, grimacing and complaining of abdominal pain along the abdomen but no apparent vomiting. It is not known exactly how long. He has had poor intake over past 2-3 weeks. This is a recurrent problem for this gentleman with severe neurologic deficit. In the emergency room CAT scan found him to have been enterocolitis, severe fecal impaction in the center of the colon there were fluid levels. He therefore was admitted. The

A 34-year-old lady suspected of acute gastroenteritis was moaning with abdominal pain in the emergency department. My patient presented with a 3-day history of abdominal pain, nausea, and intractable vomiting. She also reported a 5-day history of fever, chills, and increased frequency of urination. My patient was treated for dehydration in the ER and transferred to the medical floor for further management of acute gastroenteritis. Based on the history and physical exam, I ordered a urinalysis and discovered a urinary tract infection. Her urine culture was sent and I started her on IV antibiotics and fluids. I was amazed to see how the patient was admitted for gastroenteritis that in fact was a urinary tract infection causing her symptoms. I

The patient is 67-year-old gentleman who presented to the ED with 3 day history of rectal bleeding. He present the day of admission because the bleeding had gotten worse and it was frank blood. He was also having some epigastric pain. He has had rectal bleeding in the past. He has had polyps removed and he has also “had a vein clipped in Yugoslavia”. In the ED, he was initially hypotensive at 85/55 and tachycardic at 112. He was given normal saline and transferred to the intensive care unit. On presentation his initial hemoglobin is 11.9 and hematocrit of 35.8 and within approximately 3 ½ hours of admission his hemoglobin dropped to 10 3 and 31.4 and then subsequently to 9.5. I believe this patient's condition warranted inpatient admission

Mr. B is most likely suffering from acute diverticulitis based on his clinical presentation and workup findings. The laboratory results showed leukocytosis, hypokalemia, kidney injury, anemia, and borderline low platelet count. He also has fever and loose stool. These tests are a good start, since the patient’s past medical history is not particularly suggestive of any gastrointestinal disease, but for a definite diagnosis and to rule out complicated diverticulosis, additional tests are

Resident has been having diarrhea according to his records for the past week, since the 24th of February. He has been having two to three large loose brown stools per day primarily in the evening and at night. He has no nausea, no vomiting, no decrease in appetite, no abdominal pain and no fever. He has some vague complaints of heart burn from time to time, pain in both groins and in both legs. These complaints are