Suggest Treatment For Vomiting And Abdominal Discomfort

Posted on Tue, 13 Sep 2016

Question: Hello Experts,

My father is of 65 years old with diabities under control, After having some water in his workplace (for 3 days), generally he carries water with him, He developed vomiting and uneasiness in stomatch, Doctor suggested to have CUE where in pus cells has been observed, Doctor suggested Magnex Forte 1.5mg through IV for 3 days, during that time he suggested USG and later CT Scan, he has been diagnosed in CT SCAN KUB PLAIN the following
--> Right Kidney Normal in size and attenuation, Per and Pararenal region are normal
-> Left mild hydroureteronephrosis noted, Proximal dilated ureter, Evidence of abrupt narrowing of the middle third ureter, No evidence of any radio dense calculus noted along the left ureter.

Can you please help me what does this mean, what would be the further treatment for this condition.

Thank you...

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
Needs further tests to find out the cause of narrowing of left ureter .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that your father had undergone CT Scan (Plain) of the abdomen and Ultrasound Scanning and is detected to have obstructive uropathy on left side due to narrowing of left mid ureter.There is no stone detected in ureter .

Obstructive changes in left kidney are due to obstruction to flow of urine from kidney down into ureter resulting into accumulation of urine and there by dilatation of kidney and proximal ureter (Hydroureteronephrosis).

The primary object in such situation is to find out the cause of obstruction and narrowing of ureter which could be extraluminal (pressure over ureter from outside)or stricture of ureter.
This can be confirmed only by doing few more imaging tests like
1) Intravenous Pyelography (I.V.P) or
2) Retrograde Pyelography.(RGP)

Please consult qualified Urologist for clinical and digital rectal examination and get these tests done to confirm the diagnosis

As regards taking Imipenem .This is very expensive antibiotic hence I would suggest you to get his Urine culture test done .This will help to trace out organisms causing infection and their sensitivity pattern so that an appropriate antibiotic can be given.

Further treatment will depend upon result of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (11 hours later)

Thank you very much for the detailed explanation Sir, As requested please find the Urine Culture Report.

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
There is no evidence of infection .Mostly it has subsided .

Detailed Answer:
Hello
Thanks for follow up and uploading urine culture report .It shows that there is no infection whatever infection he had has subsided with Monosafe and he does not need to take Imipenem.

He can take urinary antiseptic like Nitrofurantoin twice daily .

Get his I.V.P done to establish cause for narrowing of left mid ureter .

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar