MRI Enterography

Kevin Henry Gallant underwent an MRI enterography. The results revealed a combination of active disease and fibrostenotic disease in a short segment of his distal small bowel.

Kevin had an adverse reaction to intravenous gadolinium and iodine IV contrast during this period.
Reference: 81

Emergency department visit after endoscopy

Kevin Henry Gallant experienced severe abdominal pain, indigestion, fever, reflux symptoms, nausea, and ulcerations following a bidirectional endoscopy procedure. In an attempt to monitor his condition, the medical team scheduled him for further diagnostic procedures and gave him a bloodwork requisition.

Mr. Gallant had Crohn's disease and his condition worsened after the endoscopy. He was given requisition for bloodwork to test for potential hepatitis b, hepatitis c, and tuberculosis. Further diagnostic procedures were arranged.
Reference: 90, 91

Initial endoscopy and assessment

Kevin Henry Gallant, with a history of Crohn's disease, underwent a bidirectional endoscopy due to increased abdominal discomfort and blood in loose stool. The procedure was more painful than previous ones he has had. The medical team planned to develop a treatment plan after the biopsy results.

Mr. Gallant's endoscopy was painful. There was an indication of disease progression as evident from the symptoms. The treatment plan was yet to be developed after the biopsy results.
Reference: 89

Emergency department visit for abdominal pain

Kevin Henry Gallant presented to the emergency department with persistent abdominal pain, reduced bowel movements, and nausea. A CT scan showed no evidence of obstruction but raised concerns about post polypectomy syndrome. He insisted on going home and agreed to take oral antibiotics if the symptoms worsened.

Mr. Gallant had persistent abdominal pain, a decrease in bowel movements and nausea. Despite the discomfort, he discharged himself from the hospital agreeing to take oral medications.
Reference: 92, 93

CT Abdomen and Pelvis Results, Updates on Crohn's disease and colonoscopy, and Emergency department visit for continued abdominal pain

1. Kevin underwent a CT abdomen and pelvis. The results showed a dilated small bowel loop but no evidence of obstruction or perforation. 2. Kevin had moderate active disease at the neoterminal ileum. His last colonoscopy showed minor aphthous ulcers in the terminal ileum. 3. Kevin Henry Gallant visited the emergency department with a tearing sensation in the left upper quadrant and chest, and numbness in the lower extremities. He was examined for abdominal aortic aneurysm, but no abnormalities were found. The medical team suspected partial or early bowel obstruction and suggested another CT scan in the morning. However, Kevin declined to stay at the hospital.

1. This test did not show any signs of obstruction or perforation. 2. Kevin has been advised to lose weight to manage his symptoms better. 3. Mr. Gallant reported new symptoms of tearing sensations in his chest and numbness in the limbs. Despite the medical team's recommendations for another CT scan, he opted to leave the hospital.
Reference: 83, 82, 94, 95, 96

Kevin Gallant's Motor Vehicle Collision

Kevin Gallant, a 46-year-old patient, was involved in a motor vehicle accident resulting in a rear-end collision. This caused various physical damages including neck pain, headaches, lower back pain, and leg pains. He also experienced visual disturbances such as trouble focusing his eyes at night, loss of vision in his left lower quadrant, and sensitivity to light (photophobia). These symptoms progressively got worse over time.

Kevin was receiving physiotherapy and massages three times a week which provided some relief, but he had to stop as his insurance coverage ended. He reported experiencing a burning sensation, numbness, pins and needles, and a throbbing sensation in his right leg and foot while sitting. He also experiences muscle cramping in his thigh when he lies down. Additionally, he reported significant lower back pain while driving and inability to drive over long distances. His pain worsens with activity and he experiences shooting pain to his right hip that changes to a throbbing sensation at rest. No similar symptoms were reported on his left side.
Reference: 33, 34

Motor Vehicle Collision Involving Kevin Henry Gallant

1. Kevin Gallant was rear-ended in a motor vehicular collision, causing him to hit his head. Resultant physical conditions include neck and back pain, leg pain, numbness, tingling sensations, and headaches. He also noted experiencing altered sleep patterns, depressed mood, anxiety, and cognitive issues. The post-incident symptoms have negatively affected his professional life as a truck driver, daily household tasks, and recreational activities. For pain relief, he is currently medicating with Percocet. 2. Kevin Henry Gallant was involved in a motor vehicle collision where he was rear-ended. Upon occurrence, Kevin was able to exit the vehicle and interact with the other driver. However, after some time, he started experiencing escalating neck and back pain. After medical assessment, he was diagnosed with whiplash-associated disorder grade 2, cervical\/lumbar spine injuries, a left trapezius injury, and a concussion. Additionally, it was reported that he started showing post-concussive symptoms and a likelihood of a flare-up in an underlying left ulnar neuropathy. Multiple subsequent medical evaluations and tests were conducted to monitor Kevin's conditions and to establish an effective treatment protocol.

1. The accident has led to a combination of physical and mental health issues. These have far-reaching consequences on his personal and professional life. The analgesic Percocet is important in managing his chronic pain but needs to be considered for its potential side-effects and dependency risk. 2. The accident led to the diagnosis of several severe body injuries including a concussion, whiplash-associated disorder grade 2, and cervical\/lumbar spine injuries. Kevin also started showing signs of post-concussive symptoms and a potential exacerbation in his underlying left ulnar neuropathy.
Reference: 4, 5, 6, 7, 8, 9, 10, 11, 54

Bloodwork Results

Kevin's most recent bloodwork showed normal levels of sodium, potassium, chloride, random glucose, creatinine, and eGFR. His CRP was 1.5, and his white blood cell count, hemoglobin, and platelets were within normal limits.

Bloodwork did not show any abnormalities.
Reference: 84

Status of Health Condition

Kevin continually suffers from symptoms such as frequent liquid bowel movements, blood and mucus in the stools, and occasional dark stools. He also has crampy abdominal pain, urgency, and significant nausea. He's now eating a low-residue diet and has occasional periods of 24 hours without bowel movements, accompanied by nausea and avoidance of solid foods.

Kevin's symptoms are not improving despite dietary changes.
Reference: 85

Chest X-rays

A set of diagnostic chest X-rays was performed to investigate the patient's chest.

This is the earliest medical procedure performed on the patient as indicated by the records. It could give insights on the severity and type of injury.
Reference: 75

Lifestyle and Family History

Kevin reveals he vapes, previously smoked cigars, and denies recreational drug and alcohol use. He has significant allergies to contrast dyes, Methotrexate, and Imuran. His family history includes Crohn's disease, colitis, polyps, and a genetic cancer affecting multiple family members.

He has quit smoking cigars 3 years ago.
Reference: 86

Current Medical Treatments

Kevin has been off any medical therapy for Crohn's disease for over 7 years. However, his symptoms persist.

Consideration is on the possibility of using biologic drugs for Kevin's active Crohn's disease after further evaluation.
Reference: 87

Follow-up

Upcoming actions involve exploring the use of biological drugs for Kevin's active Crohn's disease, requiring further evaluation.

Kevin's treatment is under review, and potential new treatments are being considered.
Reference: 88

Immunology Tests, Chest X-rays, and Electrocardiogram (ECG)

1. Immunology tests were performed to measure the patient's C-reactive protein (CRP) level. 2. Another set of diagnostic chest X-rays was performed to investigate the patient's chest. 3. An Electrocardiogram (ECG) was done to evaluate the patient's cardiac function.

1. CRP level assessment could be signaling the detection or monitoring of inflammation or infection in the body. 2. This is the second set of chest X-rays indicating continuous assessment of the patient's health status. 3. The performance of ECG signals the investigation of potential heart-related issues possibly linked to the injury.
Reference: 78, 74, 76

Medical Investigation Related to Crohn's Disease Symptoms

Kevin Gallant, a 46-year-old man, visited Queen Elizabeth Hospital due to an intensification of his Crohn's disease symptoms. To identify the cause of this worsening condition and develop a treatment plan, he underwent two medical procedures: a gastroscopy and a colonoscopy. The gastroscopy uncovered the existence of distal esophagitis and a small hiatus hernia. Additionally, it detected a normal-looking neoterminal ileum and colon. Biopsies were obtained from the antrum and body to check for H. pylori. The colonoscopy also highlighted minor changes at the anastomosis and normal neoterminal ileum. Furthermore, no active inflammation or colon polyps were spotted.

Kevin Gallant was diagnosed with distal esophagitis and a small hiatus hernia. He was found to have a normal neoterminal ileum and colon from the gastroscopy. The biopsies taken aimed to exclude the likelihood of H. pylori. Moreover, it was discovered in the colonoscopy that there were mild changes at the anastomosis and there weren't any signs of active inflammation or polyps in the colon.
Reference: 65, 66, 67, 68, 69, 70, 71, 72

Blood Culture

Blood cultures were taken from the patient.

Blood cultures would indicate infections present within the blood that could have resulted from the injury.
Reference: 73

Patient's presentation to Queen Elizabeth Hospital's emergency department and Further tests conducted on the patient

1. The patient, Kevin Henry Gallant, presented to Queen Elizabeth Hospital's emergency department with abdominal pain, possibly due to Crohn's disease. Abdominal radiographs were taken. His vitals were also checked, and no significant abnormalities were observed. 2. Further radiographs were taken, which included a diagnostic chest radiograph. The patient also underwent laboratory tests which included routine biochemistry, blood gases, and immunology. The tests were ordered by Dr. Harrison C. Carmichael.

1. Patient's complaint was abdominal pain. Abdominal radiographs showed non-dilated loops of small bowel and large bowel and no evidence of ileus or obstruction. No free intra-abdominal gas or aspiration was observed. 2. Laboratory results show normal sodium, potassium, chloride, total CO2, anion gap, glucose, creatinine, eGFR, lactate, CRP, blood gases, total protein, albumin, bilirubin, ALT, AST, GGT, alkaline phosphatase, and lipase levels.
Reference: 41, 42, 43, 44, 45, 46, 47, 48

Unscheduled Office Visit due to Ongoing Abdominal Pain

Kevin Gallant visited the office without an appointment due to ongoing abdominal pain. His symptoms included a tearing sensation and burning sensation in his abdomen, which started around Christmas. Despite previous emergency room visits and tests showing no abnormalities, he continued to be in discomfort.

Kevin's pain started around Christmas. Suggestions were made that his symptoms were more aligned with gastritis rather than a flare of his Crohn's disease. He was advised to increase his Pantoprazole dose and avoid trigger foods. Discussion on use of prednisone was made without initiation.
Reference: 31, 32

Kevin Gallant's Health Improvement Report

Kevin Gallant contacted the doctor's office reporting 75-80% improvement in his health since the last consultation. He mentioned occasional bloating and pain after supper, which resolved by the morning after a bowel movement.

Kevin was advised to continue taking Pantoprazole, avoid trigger foods, and take prednisone if symptoms worsened during his trip to Mexico. He was encouraged to seek medical care if he had any new or concerning symptoms.
Reference: 30

Symptom Flare-Up during Mexico trip