AM REPORT FINAL

Final Diagnosis

• Hepatic Flexure Intramural Colon mass further evaluation needed
• Partial Small Bowel Obstruction
• Vitamin D deficiency
• AKI on CKD stage 3-4 (Baseline not known) likely prerenal Azotemia secondary to dehydration

Take Home Teaching Points

• Patient presenting with cyclic constipation and diarrhea should be worked up first for Partial Bowel Obstruction
  • Infectious causes are unlikely to cause constipation
  • Inflammatory syndromes would be next on differential
  • First imaging should be Abdominal Xray
• Colonic Wall Masses
  • Check Cancer markers, CEA
• Causes of Hypocalcemia
  • First correct for albumin
  • Check Phosphate, Vitamin D, PTH
  • Hypoparathyoidism
  • Vitamin D deficiency
  • Pseudohypoparathyroidism

– Copyright Dr. Geetha Krishnamoorthy ABIM Board Review Study Guide