Cholelithiasis

 Clinical Features:

• 1)Sudden and rapidly intensifying pain in the upper right portion of your abdomen.
• 2)Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone.
• 3)Back pain between your shoulder blades.
• 4)Pain in your right shoulder.
• 5)Nausea or vomiting.

Investigations:

• 1)CBC 
• 2)usg of W/A 
• 3) ALT
• 4)SGPT 
• 5)ECG
• 6)serum electrolyte

Rx:

• Bed rest
  
•  Diet: NPO TFO
  
• NG Suction - 2 hourly
  
• Continuous Catheterization
  

1.  Inf Hartsol (2L)+5% DNS (1L)

• I/V@30 d/min
  

2.Inj. Ceftron(ceftriaxone) (1gm) 

• 1 vial ...IV......... BD

3.Inj. Filmet(metronidazol) (500mg/100ml) 

• 1 bag........ IV....... TDS

4. Inj. Maxpro(Esomeprazol) (40mg) 

• 1 vial....... I........  BD

5. Inj. Torax (ketorolac)(30mg) 

• 1amp...... 1/M........ TDS/sos

If Severe Pain:

6. Inj.Nalbun-2(Nalbuphine)

• 1 ample I/M stat 

+(plus)

Inj. Vergon (12.5mg)

• 1amp...... I/M- stat & sos
  

 Discharge Treatment:

1.Cap.Denver([post id="399" title="Cefixime"]) (200mg)

• 1+0+1……...7 days

2. Tab.Fimet ([post id="406" title="Metronidazole"]) (400mg)

• 1+1+1………..5 days

3.Cap.sergel ([post id="392" title="Esomeprazole"]) (20mg)

• 1+0+1………..14 days

4.Tab.Rolac([post id="450" title="Ketorolac"])  (10mg)

• 1+0+1(after meal) ….5 days

5.Tab.Rivotril([post id="474" title="Clonazepam"]) (0.5mg)

• 0+0+1……..15 days

6.Tab.CEEVIT([post id="466" title="Ascorbic"] Acid)(250mg)

• 1+0+1……...10 days

7.Tab.Xinc-OT([post id="470" title="Zinc"])

• 1+0+1…………1 month

❣️❣️বিখ্যাত হওয়ার প্রথম পদক্ষেপ হচ্ছে বিশ্বাসী হওয়া-ওয়ান্ট হুইটম্যান।❣️❣️