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Profile of Adult Patient Case 00-044
Document summary
Acute admission with Right Iliac Fossa pain (RIF). Sudden onset RIF pain constant dull ache;
intermittent sharp pain; Pain increases when laying flat; vomited coffee ground; nauseated
occasionally. Diagnosed with acute appendicitis.
Appendecectomy performed moderately inflamed appendix found, terminal ileum caecum
normal. Uneventful post operative recovery. Home on antibiotics.
Profile of Adult Patient Case 00-046
Document summary
Acute admission with intermittent Right Upper Quadrant pain (RUQ) for past four days
increasingly severe on day of admission. Pain associated with bilious vomiting that relieved
the symptoms. Pain radiates to the back and she has been shivering ? Rigors.
Has had Ultrasound Scan (USS) recently that reported a Gall Bladder (GB) full of calculi and
a soft tissue mass within Common Bile Duct thought very unlikely to be a tumour.
Symptoms settled on conservative treatment including antibiotics. Underwent uneventful open
Cholecystectomy on day sixteen. Uneventful post operative recovery apart from one episode
of fluid overload causing oedema (requiring rings to be removed) treated with diuretics.
Histology of the gall bladder reported an adenocarcinoma completely enclosed and therefore
excised with the gall bladder. Discharged circa day twenty-five.
Profile of Adult Patient Case 00-047
Case summary
Admitted from clinic. Three month history of intermittent burning/crushing epigastric pain.
One episode of bilious vomiting and diarrhoea, several weeks of severe itching. Ten day
history of increasing jaundice, dark urine, pale stools.
A battery of tests and investigations are performed to establish the aetiology for the jaundice.
Ultrasound Scan is reported as normal particularly with no biliary obstruction. Liver biopsy is
performed and reported as ….cholestasis and focal lobular inflammation. Extrahepatic (large
duct) obstruction and a drug reaction should be considered in the first instance.
Discharged home on day twenty-two with no definitive diagnosis and for follow up in clinic.