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Case Report | DOI: https://doi.org/10.31579/2578-8965/010
Heart of Georgia Women’s Center, Warner Robins, GA, USA
*Corresponding Author: Mohammad S Walid, Heart of Georgia Women’s Center, Warner Robins, GA, USA, E-mail: msvalid@gmail.com
Citation: Mohammad S Walid, (2018) Brown Semen: Think of Necrotizing Pancreatitis.J. Obstetrics Gynecology and Reproductive Sciences, 2(2). doi. 10.31579/2578-8965/010
Copyright: © 2018 Mohammad S Walid . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 13 June 2018 | Accepted: 13 August 2018 | Published: 15 August 2018
Keywords: necrotizing
Pancreatitis is a common medical problem frequently encountered by hospitalists among alcohol abuse patients. It usually presents with abdominal pain with nausea with or without diarrhea. In severe cases, pancreatitis may be complicated by necrotizing process.
Pancreatitis is a common medical problem frequently encountered by hospitalists among alcohol abuse patients. It usually presents with abdominal pain with nausea with or without diarrhea. In severe cases, pancreatitis may be complicated by necrotizing process.
Cullen's sign of pancreatitis is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. The sign takes 24–48 hours to appear and can predict increased mortality. In more severe cases, it may be accompanied by Grey Turner's sign (bruising of the flank)indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding. Our case have an interesting presentation from which we can learn a new sign.
This is a 31 yo man of thin body habitus who presented to ED with complaints of abdominal pain, back pain and left hip pain. The patient has been complaining of pain "for a long time." Denies fever, chest pain, or shortness of breath. He has h/o alcohol abuse and chronic pancreatitis and recently spent 3 weeks at a bigger hospital in a nearby town then moved back to Fond du Lac. Patient also smokes. Walks with a cane. During interview he reported brown semen. Denies change in urine color or urinary discomfort. Last HIV test 2 years ago. Patient said he is heterosexual, lives with parents, unemployed, smokes >1 pack a day, drinks vodka, and denies illicit drugs. His home meds are mirtazapine, sertraline, lorazepam, oxycodone and potassium supplement. On arrival, vitals showed accelerated heart rate 143 bpm and normal other parameters: blood pressure 111/78, temperature 98.6 F, and respiratory rate 20 bpm. On physical exam, lungs clear to auscultation, no abdominal tenderness, and no scrotal swelling but there is limitation in ROM of
left hip. CT abdomen and pelvis showed necrotizing pancreatitis with extension from the pancreatic tail inferiorly along the Gerota's fascia contacting the left psoas and iliacus muscles (see pictures). EKG is sinus tachycardia. Labs show increased white count and ketones as well as decreased hemoglobin, potassium, and albumin. Lipase mildly elevated. Bacteriological studies showed he was MRSA carrier and was positive for C. Diff. in stool.
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