Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add filters








Year range
1.
Article | IMSEAR | ID: sea-215256

ABSTRACT

A 63 years old male patient was admitted with complaints of acute pain in abdomen and nausea since 1 day. He had no history of chest pain, palpitations, shortness of breath, orthopnoea, paroxysmal nocturnal dyspnoea. There was no history of constipation or obstipation, vomiting’s, haematuria, or oliguria. Patient had a past history of systemic hypertension, diabetes, IHD since last 8 years. He was non-smoker, non-alcoholic. On examination, he was mesomorphic, febrile, had pulse rate of 146 bpm, irregularly irregular, his blood pressure was 134 / 86 mmHg. He had bilateral pitting oedema feet and on abdominal examination, there was diffuse tenderness in all the quadrants of abdomen. Guarding or rigidity over the abdomen was absent.ECG was suggestive of atrial fibrillation with fast ventricular rate as shown in figure 1. Haemoglobin 12.8 gm per dL, WBC - 24,900 cells / cumm, CKMB - 6, Troponin I was negative, serum cholesterol - 95 mg / dL, serum triglycerides - 91 mg / dL, LDL - 63 mg / dL, VLDL - 18 mg / dL, HDL - 14 mg / dL, serum LDH - 382 U / L, CRP - raised, D - dimer was positive, CHA2DS2 - VASC score was 4 and HAS - BLED score was 3. In view of persistent acute pain in abdomen, he underwent CECT abdomen which was suggestive of hepatosplenomegaly with hyper dense liver with multiple splenic and renal infarcts as shown in figure 2. 2D ECHO findings were dilated cardiomyopathy with congestive cardiac failure (ischemic) with 40 % left ventricular ejection fraction. He underwent coronary angiography, which revealed ischemic heart disease.

2.
Article | IMSEAR | ID: sea-215190

ABSTRACT

Blunt trauma to abdomen is one of the common causes for morbidity and mortality. In blunt abdominal trauma, there may be trauma to the pancreas, tear of bowel and hollow viscous, which can result in elevated levels of serum amylase and lipase. Serum amylase and mainly serum lipase are diagnostic markers for pancreatitis according to some literature. We report a young male, who presented with complaints of acute abdominal pain, constipation and vomiting after blunt abdominal trauma with elevated serum amylase and lipase levels with normal pancreas. Initial assessment of intra-abdominal pathology due to blunt abdominal trauma is often challenging as many injuries may not manifest during the treatment period. The manifestations may vary from being simply asymptomatic to life threatening injuries due to unavailability of accurate information about the nature of trauma. Hence, accurate diagnosis becomes very important in the management. Injury to the pancreas is not common and can result from direct penetration or through the transmission of blunt force to the retroperitoneum. Some studies report an incidence of 0.2 % cases for blunt trauma up to 1.1 % cases for penetrating trauma.1 The role of ultrasonography (USG) and Computed Tomography (CT) in management of Blunt abdominal trauma is well established. But the role of laboratory tests in the evaluation of these patients is controversial.2 In cases of Blunt trauma to abdomen, lot of causes found to cause serum amylase and serum lipase levels tend to raise. Some of these causes can be pancreatic, rupture of hollow viscus or bowel, facial and brain injury.3 It has also been found that reduced clearance of lipase can be caused by renal impairment. Thus non‐pathological raise in level of pancreatic enzymes, and other miscellaneous causes such as diabetes mellitus, drugs and infections shall be included as alternative pancreatic diagnoses.3

SELECTION OF CITATIONS
SEARCH DETAIL