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What Causes Severe Abdominal Pain Along With Swollen Legs?
Question: Hi can you please advise what could possibly be the underlying condition or diagnosis for the following....abdominal rigidity voluntary guarding, crp of 307 and rising..mother in severe pain ...has a history of diverticular disease in fact had a colon resection and fistula op exactlt 4 years
rior..high wcc and low albumin ... found blood clot in her private are not sure if from her vagina or anus but it seemed to be mixed with a mucos..also her legs are swelling up quite a lot..she has been assested high risk VTE...what should i do or request to be done..money is not a issued and we can afford any.procedure
rior..high wcc and low albumin ... found blood clot in her private are not sure if from her vagina or anus but it seemed to be mixed with a mucos..also her legs are swelling up quite a lot..she has been assested high risk VTE...what should i do or request to be done..money is not a issued and we can afford any.procedure
Brief Answer:
sounds like an emergency! Peritonitis possible
Detailed Answer:
Hello,
it sounds like a medical emergency. The abdominal rigidity, the high white blood cells count and the very high CRP are all findings consistent with serious abdominal infection. The formation of a fistula in the past indicates that her abdomen is 'complicated'. Many things can go wrong after such an extensive operation.
The blood clot could be from her anus. Inflammed diverticula sometimes rupture and may cause bleeding. The low albumin level probably indicates that her condition has evolved over some days but it also depends on her previous condition.
She needs to be taken to the ER right away. Clinical examination data are of outmost importance and I couldn't have them through this conversation. An abdominal CT scan would also be very useful as it may detect the inflammation site. Depending on the findings more tests might have to be needed. If it is an abscess, then CT-guided drainage or surgical approaches might have to be tried.
So in conclusion, it sounds like a peritoneal inflammation caused by some kind of rupture in the intestine (diverticula? other causes?). Clinical examination and an abdominal CT should clarify the situation.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Best wishes for her health!
sounds like an emergency! Peritonitis possible
Detailed Answer:
Hello,
it sounds like a medical emergency. The abdominal rigidity, the high white blood cells count and the very high CRP are all findings consistent with serious abdominal infection. The formation of a fistula in the past indicates that her abdomen is 'complicated'. Many things can go wrong after such an extensive operation.
The blood clot could be from her anus. Inflammed diverticula sometimes rupture and may cause bleeding. The low albumin level probably indicates that her condition has evolved over some days but it also depends on her previous condition.
She needs to be taken to the ER right away. Clinical examination data are of outmost importance and I couldn't have them through this conversation. An abdominal CT scan would also be very useful as it may detect the inflammation site. Depending on the findings more tests might have to be needed. If it is an abscess, then CT-guided drainage or surgical approaches might have to be tried.
So in conclusion, it sounds like a peritoneal inflammation caused by some kind of rupture in the intestine (diverticula? other causes?). Clinical examination and an abdominal CT should clarify the situation.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Best wishes for her health!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr, can you be so kind as to advise me
with a few of the clinical data that is important for me to ask or be aware...At the moment a CT scan has been requested in emergency...
with a few of the clinical data that is important for me to ask or be aware...At the moment a CT scan has been requested in emergency...
Brief Answer:
abdominal examination
Detailed Answer:
Hi,
A full abdominal examination is required. Auscultation may reveal abnormal or absent intestinal sounds. Normal bowel sounds are very much against intraperitoneal inflammation.
Palpation of the abdomen will the doctor determine sites of tenderness or increased rigidity. Generalized peritoneal irritation can be revealed with certain signs.
Percussion may raise suspicion for rupture of a hollow organ.
General examination is important. Signs of increased severity include a high pulse rate and hypotension. An increased respiratory rate is another sign of serious condition.
I'm sure the doctor has already evaluated all the above since a CT scan was ordered.
Kind regards!
abdominal examination
Detailed Answer:
Hi,
A full abdominal examination is required. Auscultation may reveal abnormal or absent intestinal sounds. Normal bowel sounds are very much against intraperitoneal inflammation.
Palpation of the abdomen will the doctor determine sites of tenderness or increased rigidity. Generalized peritoneal irritation can be revealed with certain signs.
Percussion may raise suspicion for rupture of a hollow organ.
General examination is important. Signs of increased severity include a high pulse rate and hypotension. An increased respiratory rate is another sign of serious condition.
I'm sure the doctor has already evaluated all the above since a CT scan was ordered.
Kind regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok ... The ecg revealed a abnormal report...sinus tachycardia short pr interval..so far..will advise ... Im worried about agonal event maybe dvt and PE ..
Brief Answer:
these are expected findings
Detailed Answer:
The ECG findings you've mentioned are expected because of her general condition. Abdominal pain and rigidity have nothing to do with either DVT or PE. I'm sure the CT scan would be enlightening...
these are expected findings
Detailed Answer:
The ECG findings you've mentioned are expected because of her general condition. Abdominal pain and rigidity have nothing to do with either DVT or PE. I'm sure the CT scan would be enlightening...
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
We have multiple bowel perforations and adhesions holes in sigmoid colon.and lots of puss and peritonitis etc.and severe abdominal infranel aorta going into the illiac vesels..her legs have swollen right up and they are concerned about dvt from her lower calves and pe to her lungs etcetc..
Brief Answer:
the findings are the expected ones
Detailed Answer:
Unfortunately I was right in my guess. It's a hollow organ rupture into the peritoneal cavity. I suppose the surgeons have taken over.
I don't understand the "infranel aorta" part. Perhaps a misspelling? Infrarenal aortic diameter? An aneurysm?
Regarding the swollen legs, DVT is always a concern. An ultrasound scan (triplex) of the leg veins would clarify things.
Kind Regards!
the findings are the expected ones
Detailed Answer:
Unfortunately I was right in my guess. It's a hollow organ rupture into the peritoneal cavity. I suppose the surgeons have taken over.
I don't understand the "infranel aorta" part. Perhaps a misspelling? Infrarenal aortic diameter? An aneurysm?
Regarding the swollen legs, DVT is always a concern. An ultrasound scan (triplex) of the leg veins would clarify things.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
not a aneurysm just severe calcification. .. yes infrarenal section and down to the illiac vessels not thoratic. area..its looks like there a few dvts in her legs as they wish to operate the concerns are the clots now..your were correct in your diagnosis in the first instance...thank you so much.
Brief Answer:
Her abdomen is the most urgent condition
Detailed Answer:
I couldn't judge better than her doctors of course (I'm some thousand miles away!) but from what we've discussed it seems to me that her main problem is the abdomen which needs immediate intervention. Without proper surgical care, she's going to get into septic shock very soon (if she's not shocked already).
DVT treatment is important as well. If she's got pulmonary embolism then it's ever worse.
I hope she'll find the courage to fight!
Kind Regards!
Her abdomen is the most urgent condition
Detailed Answer:
I couldn't judge better than her doctors of course (I'm some thousand miles away!) but from what we've discussed it seems to me that her main problem is the abdomen which needs immediate intervention. Without proper surgical care, she's going to get into septic shock very soon (if she's not shocked already).
DVT treatment is important as well. If she's got pulmonary embolism then it's ever worse.
I hope she'll find the courage to fight!
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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