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What Does My Scan Test Report Indicate?
Question: My son is 18 type q1 diabetic and has celiac. Brought to er yesterday w pain on right side. Scan indicate edema near cecum and appendix. Blood panels were elevated slightly but lymph was a 10. In afternoon next blood panel back to normal. Surgeon told us not sure if appendicitis. Gastrologist said believed mild appendicitis. Giving antibiotics. This morning blood panel everything normal except belrubin 3.1 high. I have heard that that level can indicate appendicitis. So after gastrologist comes in to see him they want to discharge. I do not want that till we know what is wrong. Is that reasonable?
Brief Answer:
As discussed in details.
Detailed Answer:
Hi.
Thanks for your query about your son and an elucidate history.
To recapitulate: Male/18 -type I diabetic - celiac - pain on right - ER - scan shows edema near cecum and appendix - blood panel elevated but settled - Surgeon not sure if appendicitis - Gastroenterologist believes this to be mild appendicitis - on antibiotics - bilirubin this morning 3.1 - you heard that this level can indicate appendicitis - they want to discharge after Gastroenterologist sees him - you want to know what is wrong before discharge - is this reasonable...
Yes, this is absolutely reasonable, I fully agree with your thought as we even as Doctors should know before the patient is discharged so that an appropriate further investigations and treatment can be planned.
- I hope his blood sugar panel is within normal limits in spite of additional problems.
- Are the liver panel normal except the raised bilirubin?
- The edema is near the cecum and appendix as per you have written above and this can be due to typhlitis, that is inflammation of the ileo-cecal region and is know n to occur in celiac. This does not necessarily mean that it is appendicitis.
It seems hat the appendix proper is normal in the scan.
- Surgeon is more exposed to the clinical evaluation of appendicitis that the Gastroenterologist who is more of a medical Specialist hence go by the Surgeon's opinion for appendicitis and follow the advise of the Gastroenterologist for the raised bilirubin.
I hope this answer helps you further, please feel free to ask for further relevant queries if you feel that thee is a gap of communication.
As discussed in details.
Detailed Answer:
Hi.
Thanks for your query about your son and an elucidate history.
To recapitulate: Male/18 -type I diabetic - celiac - pain on right - ER - scan shows edema near cecum and appendix - blood panel elevated but settled - Surgeon not sure if appendicitis - Gastroenterologist believes this to be mild appendicitis - on antibiotics - bilirubin this morning 3.1 - you heard that this level can indicate appendicitis - they want to discharge after Gastroenterologist sees him - you want to know what is wrong before discharge - is this reasonable...
Yes, this is absolutely reasonable, I fully agree with your thought as we even as Doctors should know before the patient is discharged so that an appropriate further investigations and treatment can be planned.
- I hope his blood sugar panel is within normal limits in spite of additional problems.
- Are the liver panel normal except the raised bilirubin?
- The edema is near the cecum and appendix as per you have written above and this can be due to typhlitis, that is inflammation of the ileo-cecal region and is know n to occur in celiac. This does not necessarily mean that it is appendicitis.
It seems hat the appendix proper is normal in the scan.
- Surgeon is more exposed to the clinical evaluation of appendicitis that the Gastroenterologist who is more of a medical Specialist hence go by the Surgeon's opinion for appendicitis and follow the advise of the Gastroenterologist for the raised bilirubin.
I hope this answer helps you further, please feel free to ask for further relevant queries if you feel that thee is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your explicit explanation. I would like to add that scan also indicate free fluid (believe it said free). Would typhlitis, which you indicated can occur with celiac, become inflamed due to gluten intake? Although we have been gluten free.
The other thing I wanted to say was since my son was diagnosed w type 1 in May of 2015 and then celiac November 2015, he has not been right. Complains of stomach aches, tired all the time. Blood tests during doc visits do not show anything off except March 2016 celiac was like 5. We r gluten free...we have gone over everything we eat and can not find what would have gluten. As a mother I have told general practitioner and his gastrologist that something is wrong/off and nothing is suggested.
The other thing I wanted to say was since my son was diagnosed w type 1 in May of 2015 and then celiac November 2015, he has not been right. Complains of stomach aches, tired all the time. Blood tests during doc visits do not show anything off except March 2016 celiac was like 5. We r gluten free...we have gone over everything we eat and can not find what would have gluten. As a mother I have told general practitioner and his gastrologist that something is wrong/off and nothing is suggested.
Brief Answer:
As discussed in details below.
Detailed Answer:
Thanks for your appreciation.
Noted your additional findings.
I would like to know a few more things:
- How much was the free fluid they mentioned?
- Scan means CT scan or Ultrasound scan?
- Please post the actual reports if possible. You may please attach with this query.
Cecum alone getting inflamed with gluten is rare to know and he is already on gluten free diet.
Since type I diabetes and Celiac is a bad combination for a young of 18 as this is the age of fully being energetic and have all the dreams and plans and all those things, I hope you understand what I mean by. Since he comes to know about these two thing in a short span of time, it is possible to consider the angle of psychological affection too.Please give a thought about this and let me know your thoughts and observations too.
He may need a booster in this regards too.
(Just a thought out of many years of practice).
Stomach ache and tired all the time can be related to the disease part or to the restricted diet and psychological as I explained above.
As for food the simple rule is to make an actual list of the foods and beverages those suit him and those which do not (and to stop altogether).
Please also watch if there are periods of days where he is seemingly absolutely fit and fine and then all of a sudden start getting 'down' - it is this time that you can catch up the cause and rectify it.
I hope this answer helps you at least a bit but definite, please feel free to interact more, it is possible that your detailed history and observations may help me/us to find the cause.
As discussed in details below.
Detailed Answer:
Thanks for your appreciation.
Noted your additional findings.
I would like to know a few more things:
- How much was the free fluid they mentioned?
- Scan means CT scan or Ultrasound scan?
- Please post the actual reports if possible. You may please attach with this query.
Cecum alone getting inflamed with gluten is rare to know and he is already on gluten free diet.
Since type I diabetes and Celiac is a bad combination for a young of 18 as this is the age of fully being energetic and have all the dreams and plans and all those things, I hope you understand what I mean by. Since he comes to know about these two thing in a short span of time, it is possible to consider the angle of psychological affection too.Please give a thought about this and let me know your thoughts and observations too.
He may need a booster in this regards too.
(Just a thought out of many years of practice).
Stomach ache and tired all the time can be related to the disease part or to the restricted diet and psychological as I explained above.
As for food the simple rule is to make an actual list of the foods and beverages those suit him and those which do not (and to stop altogether).
Please also watch if there are periods of days where he is seemingly absolutely fit and fine and then all of a sudden start getting 'down' - it is this time that you can catch up the cause and rectify it.
I hope this answer helps you at least a bit but definite, please feel free to interact more, it is possible that your detailed history and observations may help me/us to find the cause.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. In answer to pysch...yes there is clinical depression since diagnosis and is seen by pyschologist and is on anti depressant.
Scan was a contrast ct and fluid said small amount. I do not have the actual scan
Scan was a contrast ct and fluid said small amount. I do not have the actual scan
Brief Answer:
Take care abut the depression, to young to have it.
Detailed Answer:
Thanks for your feedback.
He shall get well once he comes out of the depression, as we discussed.
CT scan shows very well if appendicitis is there, it is almost a confirmatory diagnosis by CT scan as it can show appendicitis, its size, any fecoliths, lymphoid follicles, stranding of the mesoappendix etc. If the CT diagnosis is doubtful and the clinical signs by the Doctor are not very suggestive, it may not be a classical appendicitis hence thought of not operating and the raised bilirubin is another deterrent.
Take care abut the depression, to young to have it.
Detailed Answer:
Thanks for your feedback.
He shall get well once he comes out of the depression, as we discussed.
CT scan shows very well if appendicitis is there, it is almost a confirmatory diagnosis by CT scan as it can show appendicitis, its size, any fecoliths, lymphoid follicles, stranding of the mesoappendix etc. If the CT diagnosis is doubtful and the clinical signs by the Doctor are not very suggestive, it may not be a classical appendicitis hence thought of not operating and the raised bilirubin is another deterrent.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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