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Friday 5 February 2016

CASE 363: MURPHY'S SIGN POSITIVE, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM



Woman  32 yo,  3 days ago, fever and pain at  right  upper quadrand of abdomen with  MURPHY SIGN  POSITIVE  in clinical palpation.
Report of ultrasound in emergency from  a province hospital   was cholecystitis necrosis and peritonitis ( US picture).

At MEDIC, reviewed ultrasound shows US 1: CDI revealed big gallbladder and edema of the wall, no stone, no perforation. CBD is  no dilatation, no hypervascular.



US 2: fluid collecting in Morrison’s space extending to right iliac fossa.




US 3: normal scanning  at pancreas area.



Patient reports painful in pressing of ultrasound probe over gallbladder area .
Sonologist  suggested  edema of the gallbladder wall  and ascites maybe  due to hemorragic fever reaction.
Blood tests  confirmed  low WBC, low platelets, and Dengue test  IgG positive.



Based on  ultrasound  picture and  blood tests, diagnosis was infected Dengue; gallbladder edema only due to reaction. And the management for the case  is  medical follow-up in progress of disease.
Reference:
Acute Acalculous Cholescystitis and Ascites [Dengue Fever stage III]
Hình ảnh siêu âm sốt xuất huyết Dengue

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