Clinical Case Database / Category: Case Based Discussion
Latrogenic abdominal pain
Vijay Joshi MBBS MD, Shahid Noor FRCS FCEM, Ashis Banerjee MS FRCS FCEM
Foundation Years Journal, volume 2, issue 1, p.32 (123Doc Education, London, January 2008)
An 82-year-old woman was admitted from the outpatient clinic for evaluation of progressive breathlessness over the preceding four months. Examination revealed bilateral pitting oedema from the ankles to the knees, with raised jugular venous pressure. A tricuspid pansystolic murmur was noted on auscultation. Past medical history revealed atrial fibrillation, type 2 diabetes mellitus, hypertension and chronic renal failure. She had been investigated for iron deficiency anaemia four years previously, which was attributed to angiodysplasia of the midgut, and treated by electro-cauterisation. At the time of admission she was on gliclazide, bumetanide, diltiazem, pioglitazone, losartan, simvastatin. Anticoagulation for atrial fibrillation was withheld because of the previous history of angiodysplasia.
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Vijay Joshi MBBS MD
Registrar in Integrated Medicine
Chase Farm Hospital
Shahid Noor FRCS FCEM
Chase Farm Hospital
Ashis Banerjee MS FRCS FCEM (Corresponding author)
Consultant in Emergency Medicine
Chase Farm Hospital
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