Beruflich Dokumente
Kultur Dokumente
1. CHIEF COMPLAINT
•Chronic megacolon
2. HPI
3. ROS
4. SYMPTOMS
•Constipation
5. HISTORY
a. FAMILY HISTORY
•Diabetes
•Thyroid disorders
•Hypertension
•Parkinson disease
b. SOCIAL HISTORY
c. PAST MEDICAL HISTORY
•Diabetes
•Hypothyroidism
•Hypokalemia
•Parkinson disease
d. SURGICAL HISTORY
e. CHRONIC CONDITIONS
Chagas disease
Parkinson disease
Myotonic dystrophy
Diabetic neuropathy
Spinal cord injury
Paraneoplastic neuropathy
Amyloidosis
Scleroderma
Dermatomyositis/polymyositis
Systemic lupus erythematosus
Mixed connective tissue disease
Hypothyroidism
Hypokalemia
Porphyria
Pheochromocytoma
Nonfamilial visceral neuropathy
6. ALLERGIES
7. PHYSICAL EXAMINATION
• Physical examination generally reveals a distended abdomen,
which may or may not be tense.
• Tympany is invariably present.
• Digital rectal examination may demonstrate a hard mass of stool
just above the anorectal ring.
• Digital rectal examination in a patient with Hirschsprung disease
may bring about a large gush of retained fecal material.
9. TESTS TO BE ORDERED
• CBP
• Serum electrolyte
• Thyroid function test
• X-ray Abdomen
• USG Abdomen
• CT scan Abdomen
• MRI Abdomen
• colonic marker transit study
• Anorectal manometry
• Pudendal nerve latency test
• Colonoscopy
10. ASSESSMENT/PLAN
Medical Care
12. MEDICATION
•Psyllium
•Sorbitol
•Lactulose
•Senna
•Bisacodyl
•Cascara sagrada
•Polyethylene glycol (PEG) solution
•Tegaserod
13. FOLLOW UP