C10011264 / invoice 10000

SVU report attachedABNORMAL FINDINGS:GALL BLADDER: Normal width, but elongated, with the apex folded on itself. The wall was normal thickness, but was mildlyhyperechoic in appearance. Small amount of dependent debris within lumen. The common bile duct was mildly dilated,measuring up to 4mm in diameter.ASSESSMENT:Elongated gall bladder with normal thickness, but hyperechoic wall, & mildly dilated common bile duct. DDxpossible inflammatory change.Abdominal ultrasound found mild changes in the extrahepatic biliary tree, similar to (but more mild) those noted on the previousultrasound performed 18 months ago.No new pathology was noted as an obvious cause of the recent reduced appetite, with no focal GIT pathology, also no evidenceof abdominal neoplasia.Therefore, adjustment of the current empirical therapy targeting the suspected underlying chronic IBD/cholangitis, could betrialled.    Vital Signs    

Reason: SURG: SVU Abdo U/s Appointment Notes: BW sent VC 09/03    Vital Signs    

Reason: SURG: SVU Abdo U/s + Repeat BloodsAppointment Notes: BW sent VC 09/03awaiting confirmation from SVUTreatment: able to us without sedationNo change results stable, no progression of diseaseUltrasound: Full report to follow svusSVU report attachedABNORMAL FINDINGS:GALL BLADDER: Normal width, but elongated, with the apex folded on itself. The wall was normal thickness, but was mildlyhyperechoic in appearance. Small amount of dependent debris within lumen. The common bile duct was mildly dilated,measuring up to 4mm in diameter.ASSESSMENT:Elongated gall bladder with normal thickness, but hyperechoic wall, & mildly dilated common bile duct. DDxpossible inflammatory change.Abdominal ultrasound found mild changes in the extrahepatic biliary tree, similar to (but more mild) those noted on the previousultrasound performed 18 months ago.No new pathology was noted as an obvious cause of the recent reduced appetite, with no focal GIT pathology, also no evidenceof abdominal neoplasia.Therefore, adjustment of the current empirical therapy targeting the suspected underlying chronic IBD/cholangitis, could betrialled.Had to sedate to take bloodsMedetomdine 10ug/kg and methadone 0.2mg/kg im.Laboratory: Run alt, tbill, ap, albDisucssed with Chris. Given recent signs. Increase the pred from 3.75mg sid then to 5mg sid and see if signs resolve. If do then leave for few weeks, then taper    Vital Signs