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A Case of the Week

Case 24

 A forty seven-year-old male was transported to our hospital by an ambulance for general fatigue (malaise) and diarrhea early in the morning. The day before, he worked at the construction site in hot summer for 13 hours (5 am to 6 pm). He suffered from diarrhea all day. He was given a drip infusion under diagnosis of heat stroke Grade II in a local hospital. After coming back to his home, general fatigue and diarrhea continued and he lied in bed with a blanket all night because of feeling coldness. He smoked 20 cigarettes per day.
 Body (rectal) temperature at admission: 39.8°C. Laboratory test: Prothrombin time 14.1sec PTINR 1.39 D dimer 3.60 μg/ml K 3.4 mEq/L Creatinin 0.86 CRP 2.64 mg/dL White blood cells 7680/mm3 Platelets 217000/mm3, CPK 84 U/L Total bilirubin 1.07 mg/dL pH 7.465 Pneumococcus bacteria (+) in urine. Laboratory test 6 hours later: PTINR 3.82 D dimer > 80 K 4.3 mEq/L Creatinin 2.01 CRP 9.19 mg/dL White blood cells 18500/mm3 Platelets 70000/mm3CPK 214U/L Total bilirubin 2.47 mg/dL
 He received non-enhanced CT for further investigation.

What is the appropriate imaging diagnosis ?

a. Ischemic colitis

b. Infectious enteritis

c. Renal pelvis nephritis

d. Bilateral renal stones

e. Acute renal failure


1. a, c  2. b, c  3. d, e  4. a, e   5. b, e



2016.9.21



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