Case of a 33 years old female with chronic right iliac fossa pain.

September 08, 2022

Case of a 33 years old female with chronic right iliac fossa pain.

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This is the case of a 33 years old female, who is a housewife and a resident of West Bengal.

CHIEF COMPLAINT

The patient has the chief complaint of pain in the right iliac fossa from 3 years.

HISTORY OF PRESENTING ILLNESS

8/9/2022

The patient was apparently asymptomatic 5 years ago, 5 years ago, she developed pain in the right iliac fossa, over the tubectomy scar. Initially, the pain was not too much and hence the patient ignored it.

The pain was gradual in onset and continuous in nature. The pain progressively increased over time. It was aggravated by doing work and lifting heavy objects and was relieved by taking medication.

The pain became so severe that it would hinder her daily work. She also experienced multiple episodes of severe pain associated with a burning sensation over the area and a localised rise in temperature. The pain was associated with headache and nausea. The pain was radiating downwards. Not associated with fever, or swelling. With the onset of pain, the patient also started experiencing tiredness.

2.5 years ago the patient visited a doctor due to an increase in the severity of the pain. She was prescribed some painkillers, which reduced the pain. On discontinuing the medication after 15 days the pain aggravated.

She then took homoeopathic medicines for 1 year.

1 year ago she went to multiple doctors, but no permanent solution was found.

15/9/2022

The patient was apparently asymptomatic 3 years ago, 3 years ago, she developed pain over the tubectomy scar radiating to the right iliac fossa and behind to the lower back on the right side. Initially, the pain was not too much and hence the patient ignored it.

The pain was gradual in onset and continuous in nature. The pain progressively increased over time. It was aggravated by doing work for a long time , lifting heavy objects , standing for 1-1.5 hours and walking for 1 km and was relieved by taking medication.

From the past one year the pain has became so severe that it would hinder her daily work. She also experiences multiple episodes of severe pain (around two times a week) associated with a burning sensation over the area and a localised rise in temperature when she engages in strenuous work or lifts any heavy object. The pain is associated with headache and nausea. The pain is radiating to the groin, the right flank and the lower back on the right side. Not associated with fever, or swelling. During such episodes the patient is not able to bend forwards .With the onset of pain, the patient also started experiencing tiredness. For the past one year the patient has been able to do minimal housework.

One year ago she had an episode of pain, that was so severe that she could not get up from her bed.

The patient visited multiple doctors from 2020, but has not found any permanent solution. The patient has not taken any medication from the past 20 days.

She also complains of episodes of foamy stools with mucus not associated with blood, that started 15 years ago following the birth of her first child . For some time she did not get any episodes of foamy stools . After the birth of her second child , these episodes started again and are still present .The patient consumed homeopathic medicines for one year (last year) that reduced her symptoms . She has been experiencing 2-3 episodes of foamy stools with mucus every week . These episodes are aggravated by eating non vegetarian food.

3/10/2022

The patient complains of pain which is reduced in severity but has episodes in which the pain increases in severity .

HISTORY OF PAST ILLNESS

Not a known case of DM, hypertension, asthma, TB, Thyroid condition, CVD, or Epilepsy.

Surgical history - History of tubectomy 5 years ago.

FAMILY HISTORY

Father-Known case of HTN

Mother- Known case of HTN

PERSONAL HISTORY

DIET- Mixed

APPETITE- Reduced when pain increases

WATER INTAKE- 3 to 4 L a day