March 2010|Vol 7|Issue 3

March 2010 | Volume 7 | Issue 3

 

case
 
A case of Epiploic Abscess
 



 


Dr. T. Semparuthi, M.D. (hom)
22, Mariamman Koil Street,
Goripalayam,
Madurai - 625 002.
Ph : 94433 56971
Email : drsemparuthi@yahoo.com

    Introduction:

       Dr. T. Semparuthi is a leading practitioner; practices at the temple city Madurai, Tamil Nadu. He had authoured many scientific articles and also presented scientific papers in seminars. He graduated from Fr. Muller’s Homoeopathic Medical College and recently he has done his post graduation at Vinayaka Mission’s Homoeopathy Medical College, Salem. Here he presents a case of Epiploic Abscess.

       A 46 years old male, Head constable by profession consulted me for the following complaints on 17.08.2009


    Past history:
    When he was 12 years old had severe abdominal pain and had an injury to the right knee one year back

    Family History:
    Mother: H/O Haemorrhoids, hysterectomy (Dysmenorrhoea)

    Physical Generals:
    Appetite : Good(can eat only little or else<pain in abdomen)

    Diet : Mixed

    Desire : Non veg++(fish), spicy+, pickle++, sour++, (before: beef++)

    Intolerance : Spicy, non.veg<burning during stool.

    Thirst : 200ml/time, less than 2L/day

    Urine : Regular; burning micturition with red urine during fever since 10 days offensive.}

    Stool : Regular, [constipated <non veg; spicy]

    Sleep : Disturbed since 10 days. Snores during sleep

    Dream : Forgets [like falling from bridge, wakes up startles, his dead father or mother talking to him.]

    Sweat : Present, salt deposits.

    Thermal : Hot

    Has the habit of taking 2cups of tea /coffee per day and addicted to alcohol from the age of 18years.
    Sensitive to horn sound, gets irritated.

    Life space Investigation :
    Born and brought up in Chennai, got married at the age of 25.Consanguinous marriage. Has 2sons, 2nd son died 1week after birth. Siblings: 1 sister, 1 brother.

    Mind
    Angered easily and shouts harshly, beats the person whoever it is. At times there is shivering of extremities. Angered if any injustice happen beats them immediately and file a case. Once his higher officer blamed him for something which he has not done, so he couldn’t tolerate this, he beat that person (DEFIANT), and he was suspended. Cannot control his anger, he cannot sleep, difficult to get rid of it .Eyes waters during anger. Difficult to forgive till he is convinced.

    Fearless: During childhood he would play with snake. Bold to face any problem.

    Others should follow what he has decided (DICTATORIAL) or else gets angry.

    Fond of dog.

    Fasts during new moon. Prays daily.

    From the age of 18 - 21 he used to spend money well for movies etc. Helps the needy –financial etc, his eyes waters on seeing the cry of suffering people. He has no savings till now, because he used to spend well for others [needy] (SYMPATHETIC).

    Neatness is must or else he himself cleans it.

    Works even when ill.

    He slaps the accused; if others torture them he used to advice them not to do that.

    An Ultrasonogram was done on 10.08.09 which gave the impression as “A small pericolic abscess 2cm x 3cm” and on 11.08.09: C.T.Scan revealed “Evidence of inflamed, oedematous and pus filled epiploic appendicitis/diverticulitis of splenic flexure and adjacent descending colon with abscess 3.4x2.43 cm.”
    Refer Plate - I


    Problem Definition:
    Pericolic Abcess : an abscess just outside the colon as a result of perforation complicating diverticulitis. If not treated properly can go in for large abscess/acute abdomen (Peritonitis).
    Miasmatic Understanding: Syco-syphilitic
    Following rubrics were taken for analysis:

    1. MIND - DICTATORIAL, domineering, dogmatic, despotic (&Elimination) - SY COTIC

    2. MIND - SYMPATHETIC, compassionate - PSORIC

    3. MIND - DEFIANT (&Elimination) - SYPHILITIC

    4. MIND - VIOLENCE, vehemence - deeds of, rage leading to - SYPHILITIC

    Lycopodium was selected on the basis of thermal and thirst; Hot and Thirstless and 1 M was selected on the basis of the speed and severity of the disease.



    First Prescription               17.08.2009
    RX
    Lyco 1M single dose

    Follow up 1                          28.8.09
    Had high fever on 17th night and drenching sweat. Sneezing++ since 2 days >since last night (PSORIC RESPONSE). Pain abdomen better 75%. No fever. Rumbling abdomen, Appetite: Good, eats well. stool – regular, Urine - Normal
    USG: NO PERCOLIC COLLECTION VISUALISED AT PRESENT
    Refer Plate - II

    Follow up 2                           13.01.10
    Still under regular follow-up, No complaints or complications. So called surgical condition managed with Homeopathy.