BLADDER CALCULI
A 70 year old ,labourer by occupation came with chief complaints of
1)decreased urine output since 20days
2)burning micturition since 20 days
3)urgency and hesitency of micturition since 20 days
4)mass per abdomen since 15 days
The patient was apparently asymptomatic 20 days back ,then she noticed a decrease in her urine output , burning micturition,urgency and hesitency of micturition ,so she visited local hospital and investigations were done
She denies h/o fever, loin pain, hematuria.
PAST HISTORY
She was hysterectomised 18 years back for fibroid uterus.
Not a k/c/o T2DM,HTN,asthma , epilepsy,TB
PERSONAL HISTORY
Diet - mixed
Appetite - normal
Sleep- adequate
Bowel movements- normal
General physical examination
Pt is conscious, coherent, cooperative,
Vitals-
Temp- afebrile
Bp-90/50 mm hg
Pr- 86 bpm
Rr-20 cpm
Spo2- 98% on RA
Systemic examination
RS- bae+, nvbs
Cvs-S1 S2 +
P/A - distended,tenderness + a hard mass of size 12x8 cm palpable in the suprapubic region.
Cns- nad
X RAY ERECT ABDOMEN
OBG REFERRAL
UROLOGY REFERRAL
DIAGNOSIS
UROSEPSIS secondary to b/l hydro ureteronephrosis with Bladder calculi with AKI with UTI.
PLAN OF TREATMENT
Tab.NITROFURANTOIN 100 MG OD
Tab.OROFER XT PO OD
Tab. NODOSIS 500 MG PO BD
Tab.SHELCAL PO OD
Tab. LASIX 20 MG PO BD
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