*Case Analysis Patient ID: A.C, a 4 year old female from Daraga Albay. History source – Mother 100 % reliability. Chief compliant: Persistent vomiting. History of present illness: 2 weeks PTA the patient experienced abdominal pain with painful urination. No fever, no vomiting, nor watery stool. No medication nor consult was done. 7 days PTA, the patient presented with an episode of vomiting with the passage of live worms. She also experiences abdominal pain without passage of stool for 2 days. 6 days PTA, the abdominal pain was persistent and with several episodes of vomiting but no passage of live worms. A few hours of PTA, the persistence of abdominal pain, increased frequency of vomiting, and presence of abdominal distention prompted them for a consult. Past medical history: (+) Bronchial asthma with last attack 1 month ago. (-) Heart disease. Family history: (+) DM, maternal and paternal side. (-) Cancer, cardiac disease, kidney, and asthma.   Birth and Maternal history: 24 G1P1 mother with the intake of FeSO4 and Ca. She is born term, with good cry and activity at birth. With the passage of meconium @ first 24 hours of life.   Nutritional history: Exclusive breastfeeding until 1 year and 2 months, then given bear brand. Complimentary feed @ 7 months. Preferred foods are rice, fish meat, and eggs. Dewormed once @ 2 years old after passing out the worm in stool.   ROS: No weight loss, fever, headache, epistasis, and difficulty of swallowing. No coughs/colds. No palpitations, no edema, no seizures. (-) chest pains. Occasional abdominal pain with on and off passage of soft watery stool.   PE: Wt: 11 HT: 92 cms T: 38.1 deg C. CR: 115/min, RR: 32/min. HEENT: anicteric sclera, pale palpebral conjunctiva, (+) cervical lymphadenopathies. Chest and heart: Symmetric expansions. Clear breath sounds, tachycardia, no murmurs. Abd: Hypoactive bowel sounds, tympanic all over, (+) tenderness. Extremities: Full and equal pulses, CRT <2 seconds. DRE: No mass, tight sphincter tone. Empty rectal vault, (+) dark red blood on examining finger.  Imaging: UTZ - unremarkable liver, biliary tree, and spleen Abd x-ray: Complete bowel obstruction. Final diagnosis: Complete Small bowel Intestinal obstruction secondary to parasitic infection.   PLEASE ANSWER THIS QUESTION: What are the possible signs and symptoms of intestinal obstruction in the patient?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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*Case Analysis

Patient ID:

A.C, a 4 year old female from Daraga Albay. History source – Mother 100 % reliability.

Chief compliant: Persistent vomiting.

History of present illness:

2 weeks PTA the patient experienced abdominal pain with painful urination. No fever, no vomiting, nor watery stool. No medication nor consult was done.

7 days PTA, the patient presented with an episode of vomiting with the passage of live worms. She also experiences abdominal pain without passage of stool for 2 days.

6 days PTA, the abdominal pain was persistent and with several episodes of vomiting but no passage of live worms.

A few hours of PTA, the persistence of abdominal pain, increased frequency of vomiting, and presence of abdominal distention prompted them for a consult.

Past medical history:

(+) Bronchial asthma with last attack 1 month ago.

(-) Heart disease.

Family history:

(+) DM, maternal and paternal side.

(-) Cancer, cardiac disease, kidney, and asthma.

 

Birth and Maternal history:

24 G1P1 mother with the intake of FeSO4 and Ca. She is born term, with good cry and activity at birth. With the passage of meconium @ first 24 hours of life.

 

Nutritional history:

Exclusive breastfeeding until 1 year and 2 months, then given bear brand. Complimentary feed @ 7 months. Preferred foods are rice, fish meat, and eggs. Dewormed once @ 2 years old after passing out the worm in stool.

 

ROS:

No weight loss, fever, headache, epistasis, and difficulty of swallowing. No coughs/colds. No palpitations, no edema, no seizures. (-) chest pains. Occasional abdominal pain with on and off passage of soft watery stool.

 

PE:

Wt: 11 HT: 92 cms

T: 38.1 deg C.

CR: 115/min, RR: 32/min.

HEENT: anicteric sclera, pale palpebral conjunctiva, (+) cervical lymphadenopathies.

Chest and heart: Symmetric expansions. Clear breath sounds, tachycardia, no murmurs.

Abd: Hypoactive bowel sounds, tympanic all over, (+) tenderness.

Extremities: Full and equal pulses, CRT <2 seconds.

DRE: No mass, tight sphincter tone. Empty rectal vault, (+) dark red blood on examining finger. 

Imaging:

UTZ - unremarkable liver, biliary tree, and spleen

Abd x-ray: Complete bowel obstruction.

Final diagnosis: Complete Small bowel Intestinal obstruction secondary to parasitic infection.

 

PLEASE ANSWER THIS QUESTION:

  1. What are the possible signs and symptoms of intestinal obstruction in the patient?
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