Al- Haimy Mohamed Ahmed; Al- Saqeer Murad Muqbil;Abdul Kareem Zaid.
Department of Medicine, Al- Kuwait University Hospital, Sana’a University, Yemen Republic. Department of Medicine
Patient is conscious and oriented, He looks ill and slightly pale, Irritable, Feverish = 38.5 Cْ .
Pulse: regular 80 / min; Respiratory rate: 18 / min; B.P: 125 / 80 mm. Hg; Tongue was coated by whitish- brownish coating; Abdomen was soft with tenderness and mild muscles defense phenomena in the left lower quadrant by superficial palpation; No any organomegaly or palpable masses could be detected by deep palpation; No any lymph-adenopathy could be palpated; No clubbing;
CVS: Clear heart sounds, No any added sounds; Respiratory system: Harsh breathing.
Patient mentioned changes in his bowel habits as a severe constipation since 1990, which were relieved by Laxatives. He had 2 episodes
of severe constipation lasted for about 6 months- (each one)- during 1990- 1994; During this period up till 2000 he used Laxatives frequently.
Since 2000- 2007 he had yearly episodes of more severe
constipation and left lower abdominal pain with concentration in the L. iliac fossa. This last attack of constipation and abdominal pain was markedly severe and associated with fever and had a sudden onset.
In addition to this he mentioned that he had a history of upper abdominal pain, heart burn and dyspepsia, for what he used to take: Zantac- Ranitidine and Lomac- Omeprezole without physician prescription.
During the past period he was not seen by any physician. No any facts of hospitalizations.
CBC & ESR: Hb. 14 g %; Leucocytes: 13000 x 10 / l; Urine: NIL; Stool: NIL.
X- Ray and Barium study:
Radiological signs of multiple Diverticules of the sigmoid and descending colon region, mainly in the mesenteric border with aspect of adjacent colonic segment. No filling defect.
Lower GIT Endoscopy :
Under coverage of antibiotic, Partial colonoscopy was performed and reveled the following: Multiple Sigmoid