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
