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Suggest treatment for abdominal pain and fever

Answered by
Dr.
Dr. Muhammad Ali Rauf

General & Family Physician

Practicing since :2013

Answered : 1313 Questions

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Posted on Thu, 25 Aug 2016 in Digestion and Bowels
Question: So in short the letter:

Complaint
Localised belly ache - lower abdomen. Upper right part to lower right.

Anamnese
Since last night pain in lower belly. Upper part. Sometimes hurts more. She wanted to lay still and legs curled up.

Pain is getting less.
Fever 38.6 at top. (40.5 was false reading)
After paracetemol 37.

Not hurting when in a bumpy car. Miction? And stool was painfull in upperbelly when pushing. No pain when peeing.

Physical exam:
Temp 38.6. Looks sick. Sat 99% wrist 118/min regular. Rr 118/70mmhg

Abdominal: flexible, peristaltic? + wt?, pressure pain in the lower abdominal upper part with pain when letting it go. No evident resistances. Proassign negative. No hit-pain in the kidneylodges.
Vt: no up-hit or slingerpain

Crp 95

Surgeon said the pain is exactly on the spot of the appendix.
TV

The scan showned no sign of torn appendix or any leakage.


diagnosis is: pyelonefritis.


do you agree? / any suggestions for treatment?
doctor
Answered by Dr. Muhammad Ali Rauf 6 hours later
Brief Answer:
CT abdomen correlation is suggested to rule out appendicitis.

Detailed Answer:
Hello

Thank You for contacting HCM. My name is Dr Muhammad Ali Rauf & i will look into your problem.

I have gone through your query and would try to help you in the best possible way. Diagnosis of appendicitis is based clinically. Ultrasound may or may not confirm diagnosis. Another modality preferred for diagnosing appendicitis is CT abdomen. If all other causes of pain in right iliac fossa(right lower abdomen) are ruled out then on exclusion criteria diagnosis of appendicitis is achieved.
Pyelonephritis means infection of kidneys. Urine complete examination report is suggesting urinary tract infection.

As the TLC count is also raised so my suggestion would be to go for CT abdomen to rule out appendicitis. If it is ruled out then most probably pyelonephritis is the cause of pain and treatment could be started accordingly.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Above answer was peer-reviewed by : Dr. Prasad
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