أكاديمية العمل أونلاين

Dear Colleague,

I am referring a 42-year-old male patient for further evaluation and management.

The patient presented with severe right lower abdominal pain for the past two days, progressively worsening. He reports no fever, no dysuria, no hematuria, and no gastrointestinal symptoms. Appetite is preserved.

On examination, there is localized tenderness in the right lower quadrant (right iliac fossa) without rebound tenderness or guarding. Cough/percussion sign is negative, and the patient is hemodynamically stable.

Based on the clinical presentation, ureteric colic is a possible diagnosis, although early appendicitis and other causes of right lower quadrant pain remain in the differential. Further workup is required.

I recommend:

- Laboratory investigations including CBC, CRP, renal function tests, and urinalysis

- Imaging (preferably non-contrast CT KUB) to evaluate for ureteric stones and exclude other intra-abdominal pathology

- Analgesia and further management as per findings

Thank you for your kind assessment and further management of this patient.

Kind regards,

Dr. Achraf Ali