Patient case: Abdominal Wall Adhesions
A 38-year-old female presents to the clinic with complaints of chronic abdominal pain and intermittent episodes of bowel obstruction over the past six months. She has a history of laparoscopic surgery for appendicitis three years ago. The patient describes her pain as a cramping sensation in the lower abdomen that worsens after eating and improves with movement. Additionally, she reports experiencing episodes of nausea, vomiting, and constipation, which resolve spontaneously.
On physical examination, the patient appears well-nourished but is tender in the lower abdomen without rebound tenderness or guarding. Bowel sounds are present but slightly diminished. Laboratory tests show no signs of infection, and an abdominal X-ray reveals dilated loops of bowel consistent with a partial obstruction.
To further evaluate her condition, the patient undergoes a CT scan of the abdomen, which shows evidence of adhesive bands causing bowel obstruction. Given her symptoms and imaging findings, the patient is scheduled for a laparoscopic exploration to release the adhesions. She is counseled on the risks and benefits of the procedure, including the possibility of recurrent adhesions. The surgery is planned for the following week.
a). Severe abdominal pain after eating
b). Chronic abdominal pain and episodes of bowel obstruction
c). Jaundice and dark urine
d). Acute onset of diarrhea
a). Cholecystectomy
b). Laparoscopic surgery for appendicitis
c). Hernia repair
d). Ovarian cyst removal
a). MRI of the abdomen
b). Abdominal ultrasound
c). Abdominal X-ray
d). CT scan of the abdomen
a). Conservative management with dietary modifications
b). Laparoscopic exploration to release the adhesions
c). Open abdominal surgery
d). Medication for pain management only
