山东大学：《诊断学》课程教学资源（PPT课件讲稿）It's Time

It's Time .A 63-year-old woman was admitted because of severe abdominal pain, fatigue and bloody diarrhea

It's Time • A 63-year-old woman was admitted because of severe abdominal pain, fatigue and bloody diarrhea

Her symptoms had started about 3 months prior to admission.She was initially evaluated by her local physician,referred to a surgeon and underwent an exploratory laparotomy

• Her symptoms had started about 3 months prior to admission. She was initially evaluated by her local physician, referred to a surgeon and underwent an exploratory laparotomy

The surgeon described an inflamed colon and transferred her for further management to the hospital

• The surgeon described an inflamed colon and transferred her for further management to the hospital

She underwent a colonoscopy,which demonstrated mild inflammation of the rectum

• She underwent a colonoscopy, which demonstrated mild inflammation of the rectum

27/200 :013 P-A1/4 on/bielefeldt Mild inflammation in the rectum

and severe pancolitis with deep ulcers and pseudopolyps

• and severe pancolitis with deep ulcers and pseudopolyps

Severe colitis with aphthous lesions,ulcers and pseudopolyps involving the entire colon. helete

The terminal ileum was spared. Biopsies were most consistent with active ulcerative colitis.No viral inclusions were seen

• The terminal ileum was spared. Biopsies were most consistent with active ulcerative colitis. No viral inclusions were seen

She was started on prednisone and mesalamine.About 2 weeks later, she presented with worsening symptoms despite medical therapy

• She was started on prednisone and mesalamine. About 2 weeks later, she presented with worsening symptoms despite medical therapy

She was afebrile and tachycardic

• She was afebrile and tachycardic