Skip to main content

45 Year Old Female presentinng with Pain and Hardness in the Lower Abdomen 1.5 years follwoing surgery



A 45 year-old, housewife, with the history of hysterectomy 1.5 years back is complaining of generalized weakness, abdominal pain and feeling of hardness like potato below the umbilicus from last January at the site of previous surgery and was gradually worsening in intensity but improves following disappearance of the hardness. She also added that her pain aggravates during coughing. Before surgery (hysterectomy) she used to have frequent urinations and was not able to hold urine and during urination she was feeling that something is swollen and was painful. She was told to have distended urinary bladder which had to be treated by reducing its size during the hysterectomy operation. Although presently she doesn’t feel of a distended bladder but does feel the same pain.  After surgery she was not able to urinate which was managed by putting urinary catheter. She also added that few days after surgery she has had fever and infection at surgical site which was managed with some antibiotics. 

She also has a history of surgery for gall stones and appendicitis 22 years back. She has no history of diabetes mellitus and hypertension. Her parents didn’t have a history of any hernia.

She experiences pain in her both knees from past few years (didn’t remember the duration) and indigestion for which she used to take some acid reducing agents and insomnia for which she takes some sleeping pills (rivotril). Otherwise she doesn’t take any other medicines. She doesn’t chew tobacco or drink alcohol.

Her USG Lower abdomen was done which is suggestive of an incisional hernia (fig 1, 2, 3). 
Figure 1
 
Figure 2

Figure 3

Comments

Popular posts from this blog

Consent Forms

Hindi BMJ Consent form   Bengali BMJ Consent form English BMJ Consent form   Telegu BMJ Consent Form Telegu BMJ Consent Form   UDHC Consent Form                

55 years Old male with Bipolar affected disorder moving from depression to Manic to depression phase

Disclaimer:- This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here December 2017 after collecting informed patient consent (form downloadable Click Here) This is a case of a 55 years old, diabetic, hypertensive patient who was diagnosed with Bipolar affected disorder since 1995. In 1995 due to financial loss he was attacked by this condition. He was seen by Dr. D. K Agarwala and diagnosed as BPAD-Depression phase and treated with lithium, sodium valporate, propranolol, Zeptol cr, Nitrosum - S.  With the treatment he was reasonably well but every 6 months of interval he appeared to have some disturbance like didn't want to talk to anybody, forgot to smile etc. They went to the doctor and treated accordingly and was continuing the treatment.  In the year of 2013, August he was diagnosed with BPAD-severe depression phase but, he was not responding well to the medications and then they went to NIMHANS for...

60 year old woman with hypothyroidism and SIADH

This patient is a 60 year old woman with recent vomiting, coma (sodium 107) and clinical features of dull apathy, skin coarsening, bradycardia, areflexia strongly suggesting hypothyroidism. Serum osmolality and urine sodium are suggesting SIADH. Thyroid profile: Our patient's current dose of sodium is 10ml per hour and she is having mild hypotension at times and in her blood sugar recordings hypoglycemia (attached below) was noted. In brain imaging, empty Sella is noted (attached below).  Most of the data we have till now is suggesting hypopituitarism Online Discussion: