Tubovillous Adenoma Case Study

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

Robert Johnson noticed blood in his stool. For several months , he had experienced pain in his abdomen and diarrhea. What endoscopic procedure will his physician order?

Following the CT scan findings, nasogastric (NG) tube feeding was stopped immediately and general surgery team was consult. On the same day, Mr. S underwent a right hemicolectomy with end-ileostomy for ischemic bowel. The intra-operative findings include dilated right colon and transverse colon, a foot long necrotic terminal ileum, and necrotic right colon up to close to the hepatic. Brooke ileostomy was perfomed. The stoma located at right lower quadrant (RLQ) of the

Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow-up visit after his discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time for 1

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

B.S. is an 81 year old Caucasian female presenting with abdominal pain, diarrhea, nausea and vomiting in the emergency room on February 3, 2013. B.S. has a history of glaucoma, hypothyroidism, degenerative arthritis and diverticulosis. She has allergies to iodine and vicodin. B.S. is admitted for diverticulitis with possible partial bowel obstruction and hydronephrosis. B.S. was admitted on February 3, 2013 here at Verdugo Hills Hospital.

The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.

Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

He admits to a 25 pound weight gain over the last few months. The patient was

Standing too much without taking a break to sit can cause hemorrhoids to develop.” ( Hemorrhoids) Consistent anal sexual intercourse and diarrhea can also increase your risk of hemorrhoids. You’re also more likely to develop hemorrhoids if you’re pregnant. When the uterus enlarges, it presses on the vein in the colon, causing it to bulge. A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may do a different tests to check for any abnormalities within the anus. This check is known as a digital rectal test. “During this test, your doctor inserts a gloved and lubricated finger into your rectum. If they feel anything abnormal, they may order an additional test called a sigmoidoscopy.” (Hemorrhoids) A sigmoidoscopy involves your doctor using a small camera to diagnose an internal hemorrhoid. This small fiber-optic camera, called a sigmoidoscope, fits into a small tube and then inserts into your rectum. From this test, your doctor gets a clear view of the inside of your rectum so that they can examine the hemorrhoid up close. And also check if you have other unusual images in your anus. If you’re constipated, you

R.T. is a 64-year-old man who comes to his primary care provider’s (PCP’s) office for a yearly examination. He initially reports having no new health problems; however, on further questioning, he admits to having developed some fatigue, abdominal bloating, and intermittent constipation. His nurse practitioner completes the examination, which includes a normal rectal exam with a stool positive for guaiac. Diagnostic studies include a CBC with differential, chem 14, and carcinoembryonic antigen (CEA). R.T. has not had a recent colonoscopy and is referred to a gastroenterologist for this procedure. A 5-cm mass found in the sigmoid colon confirms a diagnosis of adenocarcinoma of the colon. A referral is made for