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| A 22-year-old patient with abdominal pain and history of ulcerative colitis |
- Cc: severe abdominal pain for 7 days duration
- HPI: ? History of ulcerative colitis since childhood (6 year old)
- Frequent bowel motion ( up to 10 times /day ) mixed with blood
- O/E
- The patient was in severe distress had severe pallor with agonizing abdominal
- There is marked splenomegaly
- Pcv ------------------ 22
- Wbc �---------------- normal
- Plat �----------------- normal
- Esr ------------------- normal
- Lipid profile ---------- normal
- Abdominal u/s: portal vien thrombsis, with no canalization, dialated portal vien, collaterals appear, and splenomegally,
- Splenic head is oedematous which suggest pancreatitis
- CT SCAN: confirm the above finding
- Upper OGD ------ Fail to show varcies and was normal
- Sigmoidoscopy ----- show proctosigmoiditis and biopsy was taken
- The patient has no history of any drug intake, and his lipid profile was normal
- We gave the patient
- Anticoagalation
- Mescol tab
- Tramal tab on need
- Blood transfusion
- The patient got dramatic response, his abdomianl pain decline, bowel motion less, with no blood any more
- 5 days later we repeat the abdomnal u.s which show fluid collection at the head of pancrease
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