THANGAVEL CA PROSTATEhhhjjjkkgfffhh.pptx

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1. THANGAVEL

2. CHIEF COMPLAINTS :8 1 yrs male , farmer , came with chief complaints of painless gross Hematuria with clots and burning micturition x 2 days History of presenting illness : Patient came with complaints of painless gross Hematuria with clots and burning micturition x 2 days Patient had a history of fall at home and disorientation 2 days ago H/o increased frequency, urgency, nocturia, poor stream, straining since 1 year No H/O fever/ vomiting   PAST HISTORY: Patient is not a known case of DM/SHTN/BA/TB. PERSONAL HISTORY : Nil significant

3. FAMILY HISTORY: Nil significant   O/E: Conscious, oriented, Afebrile VITALS: BP – 120/80 mmHG , PR – 80 /min   S/E: CVS – S1S2+ RS- BAE+ P/A – Soft, non-tender B/L inguinal hernia present CNS – Disoriented GENITALS Meatus Normal No phimosis B/L Testis normal DRE- Firm nontender prostate with around 1 cm nodule palpable in left lobe

4. INVESTIGATIONS: HB – 9.8 , TC –4590, PLT –1 .90 , UREA – 17 CREATININE- 0.7 SERUM ELECTROLYTES: Na-118(137-145); K-4.8;CL-84(96-106);HCO3-23 LFT- NORMAL URINE ROUTINE-PH 6.5, SG-1.015,BLOOD PRESENT,PLENTY RBCS,WBC 3-4 S.PSA-24.9  95

5. XRAY KUB RADIOLOGY:

6. RIGHT KIDNEY LEFT KIDNEY BLADDER USG KUB

7. USG KUB: RK-10.4X 4.6CM SIZE LK-10.6X4.1CM SIZE BLADDER- BLADDDER MODERATELY DISTENDED. HYPERECHOIC FREE FLOATING ECHOES NOTED IN BLADDER S/O BLADDER CLOTS PROSTATE ENLARGED 60CC FEATURES S/O BLADDER CLOTS

8. CECT UROGRAM

9. THE BLADDER IS DISTENDED AN ILL DEFINED HETERODENSE, PREDOMINANTLY HYPERDENSE MASS OF HU~ +50-90 , MEASURING 5X5.8CM NOTED WHICH ON POST CONTRAST SHOWS HETEROGENOUS ENHANCEMENT- LIKELY HEMATOMA. FOLEYS CATHETER IN SITU PROSTATE APPEARS ENLARGED IN SIZE, VOLUME ~75CC, WITH DIFFUSE HETEROGENOUS ATTENUATION. ON POST CONTRAST SHOWS HETEROGENOUS ENHANCEMENT. CLOTS NOTED WITHIN THE PROSTATIC URETHRA IMPRESSION BLADDER HEMATOMA AS DESCRIBED GRADE III PROSTATOMEGALY WITH HETEROGENOUS ATTENUATION AND ENHANCEMENT CECT UROGRAM

10. Your text here MpMRI PROSTATE

11. MRI PROSTATE IMPRESSION GRADE III PROSTATOMEGALY 1 TRANSITIONAL ZONE:MULTIFOCAL SUBCENTIMETRIC NODULAR NOTED IN THE TRANSITION ZONE-PIRADS 3 2 PERIPHERAL ZONE-APPEARS NORMAL – PIRADS 1