65 years old

female
Asian
Right lower quadrant pain(intermittent, non-radiating)- 4 days PTA
Abdominal bloatedness
Right lower hemiabdomen intestinal ileus vs. mass (UTZ)
Diabetes (5 years)
-Glicazide 60 mg 1 tab OD
S/P CS (1988, 1990)
Fever (39.1) on 1st HD
-antibotics given
procedure done on 2nd HD
normocytic normochromic anemia
leukocytosis
hypokalemia
decreased HDL
Borderline CEA (not necessary in Pathophysio. Just present the table in Sabiston for discussion)
Inc CRP
Non-specific ST T-wave changes
Atherosclerosis (aorta)
Segmental ileus (X-ray)
Thoracolumbar spondylosis
Yellowish, brown loose stool
(+) FOBT

Dry lips(may be due to medications given)

Direct tenderness on RLQ
No mass on PE

Given on admission:
-Omeprazole
-Domperidone
-Buscopan
-Glicazide (continued)
 Comorbidity
Age Race Neural Degeneration (Diabetes Mellitus
Type II)

Higher-amplitude colonic Uncoordinated colonic

contractions contractions

Increase intraluminal
pressure

Break in colonic wall integrity

Formation of diverticula

Direct tenderness
Entrapments of fecal material and
bacteria occurs in the diverticula

Right lower quadrant pain

Vascular compromise

Intestinal bacterial Abdominal

Diarrhea? loose stools
overgrowth bloatedness

Elevated CRP
Atherosclerosis Inflammation of diverticula

Leukocytosis

Fever
Positive FOBT Hemorrhage

Normocytic Normochromic Localize irritation RL hemiabdomen intestinal

anemia ileus
 Diabetes Mellitus Type II

Glicazide intake

Hyperglycemia Insulin resistance

Binding to beta cells

Sulfonyl Urea Receptor Formation of advanced Isolated decreased of HDL
(SUR1) glycosylation end products cholesterol
(AGEs)
Blocks ATP- sensitive
potassium channels Aortic Atherosclerosis

Decrease potassium efflux

Hypokalemia

Non-specific ST T-wave
changes