A CASE FROM THE PRACTICAL MEDICINE

A CASE FROM THE PRACTICAL MEDICINE
Today we discussed the case of a 22-year-old white man who was in good health prior to two days ago, when he began to have an abdominal pain. This pain was sporadic and colicky in nature. It began in the epigastrium and has since migrated to the right lower quadrant. The patient has had three episodes of vomiting associated with the pain. He has been anorectic and feverish. He has no bowel movements for two days. He reported no diarrhea, coughing with expectoration or short of breath. He has no past history or family history of abdominal pain or any other disease. The pertinent physical findings are related to the abdomen. There is extreme tenderness to palpation, especially over McBurney's point. Guarding, muscle rigidity and rebound tenderness are all present. Bowel sounds are absent. There is a difference between the axillary and the rectal temperature. His urinalysis, hemoglobin and hematocrit are within normal limits. Nevertheless, both white blood count and red rate are elevated. His chest film is clear, but in the abdominal film we observed the psoas line absent.
We established the differential diagnosis with acute pancreatitis, acute cholecystitis, myocardial infarction, gastroduodenal ulcer and perforation of an ulcer, finally, we decided the definitive diagnosis is acute appendicitis. Among the possible complications to consider are perforation, necrosis peritonitis. Therefore, the prognosis is anceps. The only possible treatment is surgical: appendectomy.

Результаты (латинский) 1:

CAUSA MEDICINAE practicus a
casu hodie commemorauimus XXII annorum album hominem sanum ante biduum, cum regnare coepisset, et abdominis dolor. Hoc ei dolorem inesse didicisset sporadic et in colico affectu naturae. Hostes demigrarent et cum initium epigastrii ius inferior quadrant. Tria cum morbo vomitus episodiis dolor. Fuerit anorectic et febricitantibus. Nulla alvum motus per biduum fuit. Id ubi Romam allatum non deiectio, sputum tussi cum vel brevis spiritus. Nulla aevi historiam sive morbo vel dolor abdominis. Pertinent ad corporis Inventiones referuntur ad abdomen. Est summa teneritudinem nimiam ad contrectationem, maxime McBurney scriptor punctum. Custodiebam, musculus rigorem et resiliant teneritudine sunt omnibus praesentibus subscribendis. Alvum sonos absentibus. Est autem differentia inter axillaribus et rectus tortor. His urinalysis, hemoglobin et hematocrit intra limites normalis. Tamen album et rubrum sanguinem comitis rate elevantur. Revomentem pectore fluctus film manifestum est, sed in abdominis film observavimus psoas line absent.
Et confirmatus est differentialis diagnosis acutis pancreatitis, acute CHOLECYSTITIS, myocardial INFARCTUS, gastroduodenalis telum foramine suo ulceris et de qua ulcus natum, tandem placuit definitivae diagnosis est acute appendicis. Inter varia quae fieri inpedimenta ut telum foramine suo consider are, necrosis peritonitis. Ergo prognosis est anceps. Potest esse nisi chirurgicam curatio est: appendectomy.