Case 13
It was 3
o'clock a.m. when she
presented to the emergency unit. She was a female, 21 year-old, diabetic
and on insulin.
She presented with sever dyspnea, orthopnea and vague diffuse abdominal
pain.
She was
quite well up to three days ago when she started to suffer. Her
suffering was progressive till reaching its maximum intensity that
night.
Examination:
-B.P.
100/70, marked pallor, cyanosis, galloping heart, diminished air entry
all over the chest with scattered crepitations.
Emergency investigations:
-S.creatinine
4.5 mg/dl, marked anemia (Hb 5 gm/dl), elevated liver enzymes, A.B.G.
showed hypoxemia, abdominal ultrasonography revealed no significant
abnormalities.
How to deal with this patient?
