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Case Study. May 2009. Mrs S age 59 with carcinoma of ovary. Intra abdominal disease Surgery no longer an option Chemotherapy options exhausted Metastases in liver and bones. Mrs S develops nausea and bloating after a small meal. What might be the cause? What would you do?.

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case study

Case Study

May 2009

mrs s age 59 with carcinoma of ovary
Mrs S age 59 with carcinoma of ovary
  • Intra abdominal disease
  • Surgery no longer an option
  • Chemotherapy options exhausted
  • Metastases in liver and bones
mrs s develops nausea and bloating after a small meal
Mrs S develops nausea and bloating after a small meal
  • What might be the cause?
  • What would you do?
mrs s now develops back pain at level of l3
Mrs S now develops back pain at level of L3
  • What investigations might you need?
  • What treatment(s) might you consider?
  • What other medication(s) might you also need to prescribe?
she now develops sciatic nerve root pain in addition
She now develops sciatic nerve root pain in addition
  • What might you need to exclude?
  • What additional analgesia might you consider?
mrs s now develops abdominal distension pain not colic vomiting and some constipation
Mrs S now develops abdominal distension, pain (not colic) ,vomiting and some constipation
  • What might the diagnosis be?
  • What would be your initial management of symptoms include?
she now develops a complete bowel obstruction with colic
She now develops a complete bowel obstruction with colic
  • How might you change your management?
  • What route would you use for medications?