Healthy MeDico

Report: CT ABDOMEN (TRIPHASIC PANCREAS). ClNICAL INFO: Recurrent pancreatitis, nausea, vomiting. TECHNIQUE: 2.0 mm reconstructed images from a scan performed on multi slice CT scan reviewed on workstation. Non-enhanced and post contrast tri-phasic CT abdomen performed in arterial, venous and delayed phases according to departmental protocol. FINDINGS: There is evidence of peripancreatic collection approximately measuring 4.8x7.7x11.7cm in AP x TR x CC dimensions with approximate volume of 216mL. This collection is extending retroperitoneal region at level of L4 vertebra. There is collection anterior to pancreatic head measuring 5x3cm. Peripancreatic fluid is noted along pancreatic body and tail extending along greater curvature of stomach as well.  There is thickening of left perirenal fascia and mesenteric root fat stranding. No evidence of splenic artery erosion or pseudo-aneurysm is noted. There is compression of splenic vein however no evidence of intraluminal thrombus is noted.

Report:  CT ABDOMEN & PELVIS WITH CONTRAST FINDINGS: Liver appear normal in size (12 6 cm) with normal order No focal lesion is noted. Air is noted in the  biliary tree suggestive of pneumobilia. No intrahepatic cholestasis noted. Gall Bladder is partially distended with oedematous walls having a calculus in GB lumen  measuring 10.7 x 10.3 mm and another in GB neck measuring 10 x 11.6 mm. Portal vein unremarkable Stent noted in CBD extending into right ane left hepatic ducts. The stent in left hepatic duct is  reaching its anterior edge. Stomach appears distended with circumferential thickening noted at pylorus abutting right lobe  of liver and pancreas, suspicious for pylorosternal growth. Spleen is of normal size and appears normal No focal lesion noted. Pancreatic outline and dimensions are unremarkable. Pancreatic duct not dilated Both adrenals are normal in dimensions. No focal deposit seen. Bilateral kidneys are normally visualized, No focal lesion, calculus or hydronephrosis

  Esophageal Carcinoma: Common Histological types: Squamous cell carcinoma (Middle Third of esophagus) Adenocarcinoma (Lower Third of esophagus) Causative Factors: Squamous cell carcinoma: Smoking Alcohol Vitamin A, C, Zinc, Molybdenum deficiency. Long standing achalasia Celiac disease Strictures  Nitrosamines diet Human Papilloma virus Adenocarcinoma: Long standing GERD  Barrett’s oesophagus Obesity High fat intake  High alcohol intake  Presenting Complaints: Dysphasia(Most Common): Initially for solids then progress to Liquid as well. Weight loss Retrosternal discomfort Anemia Cervical Lypmphadenopathy Hoarseness of voice:Involvement of recurrent laryngeal nerve or direct invasion of the tumour into vocal cord. Stridor, Coughing, choking and aspiration pneumonia.(extension of the tumour into Tracheobronchial Tree. Tylosis: Hyperkeratosis of Palms and soles. Diagnostic Points:   Age > 45 years Progressive Dysphagia Recent unintentional weight loss. Anemia (Pallor) Investigations: 

Enteric Fever (Typhoid Fever) Chief complaints: Fever that is gradually increasing to 104.9 F Headache  Vomiting  Weakness  Fatigue Loss of appetite Muscle pain Relative bradycardia Loss of appetite Abdominal pain Rash (2 to 4 mm , Rose spots) Diarrhoea Hepatomegaly Splenomegaly  Treatment duration: 7 to 14 days Diagnosis: (BASU) Blood culture: 1st week (Most Important test at disease onset) Antigen test(widal test): 2nd week Stool culture: (3rd week) Urine Culture: (4th week) Bone marrow culture: (Gold standard) Investigations:   Full blood count (CBC)    Anemia Leukopenia or leukocytosis (Absolute eosinopenia, Relative lymphcytosis) Liver Function Tests (LFTs) Ultrasonography Whole Abdomen: Hepatosplenomegaly Treatment: (1 Teaspoonful = 5ml) Syp. Cefixime 100mg/200mg (Brands: Cefspan/Cefiget= 100mg/5ml, Cefspan DS/Cefiget DS=200mg/5m) X BD Syp. Paracetamol (Panadol=160mg/5ml, Calpol=120mg/5ml, Calpol 6Plus/Panadol forte=250mg/5ml) Syp. Multivitamins/Appetite stimulant (Lysovit, Gl