04-14-2007, 01:55 PM
Patients with DM, CRF and multiple organ failure can develop acalculous cholecystitis. Acalculous cholecystitis is characterized by the absence of gallstones and sometimes even biliary sludge. These patients may not present with classical signs of cholecystitis, because of associated diabetes mellitus and multiple organ failure. U/S may fail to show evidence of gallstones or obvious signs of cholecystitis. A CT scan of the abdomen and pelvis will reveal a thickened gallbladder wall, pericholecystic fluid, gas within the gallbladder wall, and evidence of surrounding inflammation.
2. After abdominal aortic aneurysm repair and blood in the stool =>suspect ischemic colitis => do sigmoidoscopy/colonoscopy to assess colon viability, if CT scan is inconclusive, do not use Barium enema=>can cause perforation.
3. In SLE => non-erosive arthritis; In RA =>erosive arthritis: indication for starting Methotrexate
4. Kallmann's syndrome-46,XX = anosmia, hypogonadotropic hypogonadism, absent pubic, axillary hair, absent breasts, amenorrhea.
5. Juvenile angiofibroma is a highly vascular fibrous tumor that classically affects adolescent males and appears to be related to androgenic stimulation. It manifests with recurrent epistaxis.
2. After abdominal aortic aneurysm repair and blood in the stool =>suspect ischemic colitis => do sigmoidoscopy/colonoscopy to assess colon viability, if CT scan is inconclusive, do not use Barium enema=>can cause perforation.
3. In SLE => non-erosive arthritis; In RA =>erosive arthritis: indication for starting Methotrexate
4. Kallmann's syndrome-46,XX = anosmia, hypogonadotropic hypogonadism, absent pubic, axillary hair, absent breasts, amenorrhea.
5. Juvenile angiofibroma is a highly vascular fibrous tumor that classically affects adolescent males and appears to be related to androgenic stimulation. It manifests with recurrent epistaxis.