Diagnosis?????
36 years old female (Jehovah’s Witness) presented with the chief complaints of epigastric pain which is colicky in nature, jaundice. On radiological examination she was diagnosed as cholelithiasis, for that she had undergone surgery – cholecyestomy was done and discharged. After 2 years she again came to hospital with complaints of right sub costal pain, diarrhea, dyspepsia and high level of blood glucose for this, she was investigated with MRCP and several episodes of ultrasound but no abnormality detected, so she was planned for open laparatomy and during laparatomy there were Multiple RUQ adhesions and Inflamed Pancreases and managed with total pancreatectomy, postoperatively she was managed with analgesic and discharge with pancreatic replacement therapy. After 4 years she again comes to hospital with RUQ pain, diarrhea and high level of blood glucose ,on PE no any abnormality was detected….so what was she suffering from.
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Filed Under: GI
c might b suffering frm Postcholecystectomy syndrome which is in patient with h/o cholecystectomy…this can expalin loacation of pain in RUQ,diarrohea..n pt has pacreatectomy n on repalce ment heavy meal with inadequte adjustment cold result in high blood suger…
pt has n PE tht means clinically no jaundice no fever…so cant be pathlogy related to bile duct…n type of pain is also nt mention….if it was relaated to renal colic or bile duct stone pain would b agonising n main complaint…n last thing patient did nt mention abt medication so c might nt have taken medicine…so let me knw..beyond this….well done mate
Thank you manik….she was under insulin and other pancreatic enzyme replacement.
manik sounds logical…i want to know her blood count as well
normal blood count……….
The correct answer is:
she was suffering form phantom pancreas.