C09979316 / invoice 10000

Diagnostic Imaging: ABDOMINAL ULTRASOUNDPerformed by Dr Sylvana ZhuSedation: butorphanol 0.25ml/ ACP 0.04ml IVReport:- The urinary bladder was distended with anechoic urine. The bladder wall displayed normal layering definition and wall thickness of _ cm.- The left and right kidneys displayed normal size, shape, echogenicity, and corticomedullary definition. The left kidney measured _ cm in length, and the right kidney measured _ cm in length. There was no evidence of pyelectasia or ureteral dilation.- The adrenal glands displayed normal size, shape, and echogenicity. The left adrenal gland measured _ cm in thickness at the caudal pole, and the right adrenal gland measured _ cm in thickness at the caudal pole.- The spleen displayed normal shape and echogenicity. It measured _ cm in thickness at the hilus.- The liver displayed normal tapered margins, echogenicity, and overall architecture. The vasculature pattern was unremarkable.- The gallbladder contained anechoic bile. The gallbladder wall displayed normal echogenicity and thickness of _ cm.- The stomach was empty, and displayed normal rugal folds. The pyloric duodenal junction was unremarkable, with no evidence of a gastric outflow tract obstruction. The duodenum, jejunum, and colon displayed normal layering definition and wall thickness. They measured up to _ cm, _ cm, and _ cm in wall thickness, respectively. The ileocolic junction was unremarkable.- The portions of the pancreas that were visualised displayed normal echotexture, contour, and thickness. There were no visible masses associated with the pancreas.- The left and right medial iliac and jejunal lymph nodes displayed normal size and echogenicity. The colic lymph nodes were not visualised.- There was no evidence of free abdominal fluid.- There was no evidence of mesenteric inflammation.Sonographic findings:Unremarkable abdominal ultrasound1330 SZ LMOM advising abdo u/s largely unremarkable. O to call back to discuss further and organise discharge timeDischarge notes:Sheba’s abdominal ultrasound was overall unremarkable; no overtly sinister underlying causes of weight loss were identified. For completeness, further workup may consist of thoracic radiographs (to rule out pathology such as lung cancer – which is unlikely given the absence of respiratory signs). Given that Sheba is overall reasonably well in herself, and given that the bloodwork and abdominal ultrasound have been overall unremarkable, the weight loss is considered most likely secondary to muscle wastage (common in older patients).Please maintain muscle mass by encouraging nutritional intake with diets containing high quality protein, and continuing with exercise. Low impact exercise (short but regular walks, swimming) is ideal.Insurance Claim Notes:Patient was seen today for: weight loss despite good appetiteArea affected: unknownOnset of current symptoms: past 1-2 monthsSuspected cause: unknown, suspect muscle wastageIs this known to be pre-existing?: noTreatment dispensed: nil, performed abdo u/s under sedation    Vital Signs    Weight: 8.4;