60 yr old female with INCISIONAL HERNIA

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Date of Admission- 26/03/2022.

A 60 year old female presented to OPD with chief complaints of diffuse pain abdomen      since 4 months.

HISTORY OF PRESENT ILLNESS

Pt was apparently alright few years back when she noticed swelling over the lower abdomen which was insidious in onset and progressive in nature, used to increase size on coughing and reduce size on lying down. Swelling was associated with pain which was dragging type and also differ pain abdomen. 

She has a h/o constipation which is on and off.

HISTORY OF PAST ILLNESS 

No h/o Chronic cough

No h/o Bleeding PR

No h/o recent loss of weight

Underwent surgery 20 years ago for delivery.

No k/c/o DM/Asthma/ CAD/ TB.

PERSONAL HISTORY

 Appetite Normal

Bowel movement is Normal

Menstrual history

 Addictions: No

Sleep: Adequate

FAMILY HISTORY

  No  history of DM, CAD, Asthma and thyroid disorders in the family

GENRAL EXAMINATION 

Patient is conscious, coherent, co-operative.

There are no signs of icterus, clubbing, pallor, cynosis, lymphadenopathy.

There are signs of pallor, malnutrition and dehydration - mild 

VITALS

Temperature-  Afebrile

Pulse rate- 86 bpm

Respiratory rate - 14/ min

BP- 130/90

Spo2- 99

GRBS: 138%

SYSTEMIC EXAMINATION:

ABDOMEN

Shape of abdomen- scaphoid

No tenderness

Palpable mass-  Yes

Hernias orifices- Incisional Hernia

Free fluid- No

Bruits-  No

Liver- Not palpable

Spleen- Not palpable

Bowel sound- Yes

CENTRAL NERVOUS SYSTEM 

Patient is conscious 

Speech- normal

No sign of meningitis 

Motor and sensory system- Normal

Cranial nerves- intact

Investigation 

Lower abdomen:

ECG:

PLAN OF CARE: 

Hernioplasty