Case Study 2

Question 1

demonstrate where hypogastric and right illoiac regions are located

Answer 1

hypogastric : lower middle region

right iliac: lower right region of the nine abdominal regions

Question 2

what disorders are ruled out by clinical examination?

Answer 2

1. No palpable abdominal masses, no abdominal tumors, noo enlargedned viscera: no inflammation hence no disease of liver, spleen, intestines
2. No abdominal rebound pain: not appendicitis
3. A temperatue of 37 dc: no infections/inflammatory disorders

Question 3

Following further tests jane is diagnosed with endometriosis

what is happening in endometriosis that leads to janes presenting symptoms

Answer 3

1. Uterine endometrial tissue is located outside uterus
2. Most commonly att to exterior of abdominal organs like ovaries of uterus
3. This tissue responds to janes normal hormonal controls and will proliferate and slough off at the correct times each month this accumulating in peritoneal cavity causing painful adhesions around her organs- especially painful during menstruation

Question 4

what other consequences can occur in endometriosis

Answer 4

1. painful sexual intercourse
2. more severe back and
3. other abd pain
4. poss eventual infertility

Question 5

What technique is most commonly used to investigate this disorder? What would such investigation be looking for?

Answer 5

Visual laporoscopic (endoscipic investigation of outside of abdominal organs looking for adhesions

Question 6

What are the most common TM for Janes disorder? What is basis for each TM?

Answer 6

1. Jane will prob be pit on the contraceptive puill to help control the level of tissue proliferation and level of bleeding
2. If the pain does not subside suffiently she can return to the acupuncturist for complementary TM. Chinese herbs also an option
3. Counselling should be recommended since endometriosis often lead to infertility and pain on sexual intercourse which can thus interfere with interpersonal relationships
4. Hormonal TMs include oestrogen & progesterone, progesterone alone, atestosterone derivative (danazol) and GnRH. If this is ineffective then surgery to scrape off adhesions also performed. Preg sometimes leads to disappearance of symptonms. In many case no long term cure.