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Bowel wall thickening measuring upto 10mm noted in...

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Bowel wall thickening measuring upto 10mm noted in right lower quadrant of abdomen with diffused adjacent peritoneal edma. The peritoneal edma extend into periportal and pericholecystic region with diffuses thickinning of gall bladder walls. This is my ultrasound report summary dtd 28Aug20. Please clarify ? what next procedure to be followed ?

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الأسئلة المجابة 4293 | نسبة الرضا 98%

Bowel wall thickining 
bowe wall thickness if above normal is a result of acute inflammatory process involving the bowel and the surrounding tissue like the peritoneum , in addition to that the wall of Gall bladder is thickened without evidence of stones as an indication of A disease condition called Acalcular cholecystitis which result from peritoneal inflammatory process and in patients in critical illness.
The cause of bowel edema in the right side could be a result of complicated perforated Appendix or tumor in the cecum. Other diagnoses should be ruled out by further investigation in corrolation with the patient history and physical exam under close hospital observation and surgical consultation to treat the underlying cause .
Investigations 
After proper physical exam, the patient should have cbc to detect leukocytosis , Urea and creatinin to evaluate kidney function. Stool calpritectin for Crohns disease . Abdomen and pelvis CT scan with oral and IV contrast in the diagnostic modality of choice in addition to colonoscopy to detect intra-luminal conditions .
Causes 
  • Perforated Appendicitis 
  • crohns disease
  • Intestinal obstruction 
  • Terminal ilitis 
  • Colon cancer 

our advice 
the defintive cause of bowel edema should be uncovered and treated properly to avoid complications 
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