March 5, 2010

Surgery Osce Quiz 6

49 Years old Malay guy, chronic smoker, who is previously healthy presented with complaint of sudden onset of worsening abdominal pain today.

Patient start having abdominal pain since two weeks ago which is not related to meal, confined to left upper quadrant and temporarily relief by syrup MMT.

Today, the pain becomes so severe which is sharp in nature and generalized. It is worsening on inspiration and movement and associated with shortness of breath.

He denied any history of passing out black stool, vomiting blood, palpitation, symptoms of URTI and UTI.

On examination of the abdomen, the abdomen is flat and tense with guarding. It is generalized pain but more severe on the epigastric region. Bowel sound is sluggish. Per rectal examination did not show any fresh blood or malaena.

Below is the picture of his X- ray


1) Outline your findings in his chest X ray

2) What is your provisional diagnosis and give your justification?

3) How do you manage this patient?

for answer to this case, click [here]

1 comment:

  1. answer for question 3

    send patient to my lecturer


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