Laboratories & Diagnostics

Chemistry
6/5/2023
(SIMC)
Test Result Ref. Range
FBS 5.22 3.9-5.8 mmol/l
HbA1c 6.7% (H) <6.5%
Due to diabetes
Total Cholesterol 6.76 (H) Up to 5.2 mmol/l
Due to unhealthy
lifestyle
Triglycerides 2.18 (H) Up to 1.7 mmol/l
Due to unhealthy
lifestyle
HDL 0.93 (L) Female: >1.2 mmol/l
Due to
hyperlipidemia
LDL 4.84 (H) <3.88 mmol/l
Due to
hyperlipidemia

Hematology
10/27/2023
6:37 am
(SIMC)
Test Result Ref. Range/Unit
WBC 19.39 (H) 4.00-10.00 10˄9/L
Due to
Neu% 80.7 (H) 50.0-70.0 %

Lym% 11.0 (L) 20.0-40.0 %

Mon% 7.7 3.0-12.0 %

Eos% 0.4 (L) 0.5-5.0 %

Bas% 0.2 0.0-1.0 %

RBC 4.12 3.50-5.00 10˄12/L
HGB 10.7 (L) 11.0-15.0 g/dL
Due to low red blood cell count
HCT 32.7 (L) 37.0-47.0 %
Due to low red blood cell count
MCV 79.3 (L) 80.0-100.0 fL
Due to iron deficiency
MCH 26.0 (L) 27.0-34.0 pg
Due to iron deficiency
MCHC 32.8 32.0-36.0 g/dL
PLT 596 (H) 150-450 10˄9/L
Due to abnormal cells in bone marrow cause an increase
in platelets
RDW-CV 14.8 11.0-16.0 %
RDW-SD 43.6 35.0-56.0 fL
MPV 8.2 6.5.0-12.0 fL
PDW 15.7 15.0-17.0
PCT 0.488 (H) 0.108-0.282 %
Due to bacterial infection
NRBC% 0.00 0.00-9999.99 %

Coagulation Test
11/6/2023
4:09 pm
(SMC)
Test Result Reference
PT Control 12.6
PT Patient 15.0 (H) 10.9-13.9 seconds
Due to blood taking longer than normal to clot
% Activity 77.5 (L) 83.4%-125%
Due to blood taking longer than normal to clot
INR 1.36 (L) 0.751-1.17
Due to thicker blood to clot

Hematology
Parameters Result Result Result Unit Ref. Range
11/4/2023 11/6/2023 11/10/2023
2:01 pm 2:14 pm 8:36 am
Red Cell Count 3.9 (L) 4.4 x10˄12/L 4.0-6.0
Due to B
Hematocrit 0.30 (L) 0.35 0.34-0.47
Hemoglobin 96 (L) 114 113 g/L 110-160
White Cell Count 21.5 (H) 15.4 x10˄9/L 5.0-10.0
Differential Count
Lymphocytes 0.13 (L) 0.12 (L) 0.25-0.35
Due to bacterial Due to bacterial
infection infection
Monocytes 0.08 0.06 0.03-0.14
Eosinophils 0.01 0.00 0.01-0.06
Basophils 0.00 0.00 0.00-0.01
Segmenters 0.78 (H) 0.82 (H) 0.50-0.65
Due to leukocytosis Due to
leukocytosis
Blood Indices
MCV 77 (L) 80 Due to iron fl 86-110
Due to iron deficiency (L)
deficiency
MCH 24 (L) 26 pg 26-38
Due to iron
deficiency
MCHC 32 32 g/dL 31-37
RDW-CV 15.1 16.4 % 11.0-16.0
Platelet Count 586 (H) 369 x10˄9/L 150-450
Due to blood clots
forming in blood
vessels
MPV 8.5 8.5 fL 6.5-12.0
 Chemistry
Test Result Result Unit Ref. Range
11/4/2023 11/10/2023
7::06 pm 9:21 am
Creatinine 107 (H) 66 umol/L 46.00-92.00
Due to blocked
urinary tract or poor
kidney function
Potassium 3.56 3.07 (L) mmol/L 3.50-5.10
Due to
hypokalemia

Sodium 138.4 mmol/L 135.0-145.0

Serology/Immunology
11/4/2023
2:40 pm
Test Result
ABO Group O
Rh Type Positive

Transvaginal Ultrasound
5/24/2022
(ISSHI)
• Transvaginal scanning shows a normal-sized anteverted uterus measuring about 7.0 cm x 4.7 cm x 4.0 cm
(LxWxAP), The posterior wall and anterior shows coarse parenchymal echopattern. No focal mass noted.
• Endometrial stripe is intact with bilaminar thickness of 0.3 cm.
• Cervix shows homogeneous parenchyma. There are cystic structures seen with the largest noted in the
cervical region measuring about 1.1 cm in widest transverse diameter.
• Both ovaries are not visualized due to overlying bowel gas echoes.
• No evident adnexal mass seen. No fluid noted within the cul- de- sac.

Impression:

Normal-sized anteverted uterus with adenomyosis and endometrium probably at proliferative phase.
Nabothian cysts, cervical region.
Unremarkable adnexae.
 Transvaginal/Transabdomilan Ultrasound
10/27/2023

UTERUS:
Position: Anteverted
Texture: Hemogenou; Coarse
Size: 7.7 x 6.1 × 4.2 cm (Lx W x H)
Findings: No definite mass seen

CERVIX:
Findings: 3.1 × 2.9 x 3.0 cm
Intact endocervical canal and homogenous stroma.

ENDOMETRIUM:
Thickness: 0.3 cm
Texture: Hyperechoic
Cycle compatibility: Athropic
Findings: Intact subendometrial halo

RIGHT OVARY:
Size: not seen

LEFT OVARY:
Size: not seen

CUL DE SAC: There is no fluid

Impression:

NORMAL SIZED ANTEVERTED UTERUS WITH THIN ENDOMETRIUM

* PLEASE CORRELATE CLINICALLY. Suggest whole abdominal ultrasound

ULTRASOUND of the WHOLE ABDOMEN

10/28/2023
(ISSHI)
• There is a complex heterogeneous mass with irregular borders in the hypogastric area superior to the uterus
and urinary bladder measuring about 10.5 × 10.6 x 6.9 cm.
• The liver is enlarged (mid-hepatic length - 15.0 cm) exhibiting diffuse increase in parenchymal echogenicity.
• No focal mass noted. Portal vein and its tributaries are unremarkable.
• The common bile duct measures about 0.3 cm which is within normal size. Intrahepatic ducts are not dilated.
• The gallbladder is normal in size and configuration. There is a tiny hypochoic focus adherent to the posterior
wall measuring about 0.4 cm. The wall is not thickened. No pericholecystic fluid collection noted.
• The pancreas shows homogeneous parenchymal echopattern. The head, body and tail are all within normal
size. No peripancreatic fluid collection seen.
• The spleen is not enlarged with homogeneous parenchymal echopattern. There are no masses noted. The
splenic vessels are not dilated.
• The right kidney is normal in size measuring about 11.7 x 5.6 x 4.9 cm (LxWxAP) exhibiting homogeneous
parenchymal echopattern. No evident lithiasis or focal mass noted. Its pelvocalyceal system is not dilated.
• The left kidney is normal in size measuring about 11.9 × 5.1 x 5.3 cm (LxWxAP) exhibiting homogeneous
parenchymal echopattern. No evident lithiasis or focal mass noted. Its pelvocalyceal system is not dilated.
• The urinary bladder is inadequately filled. The wall is however diffusely thickened. No evident lithiasis seen.
• Transabdominal pelvic ultrasound shows a normal-sized anteverted uterus measuring about 5.8 x 5.2 x 4.5
cm (LxWxAP). Parenchymal echopattern is homogeneous. No focal mass noted. Endometrial stripe is intact
with bilaminar thickness of 0.9 cm.
• Both ovaries are not visualized. No evident adnexal mass seen. No fluid noted within the culde sac.
• Abdominal aorta is normal in size. No aneurysmal dilatation noted.
• No evident para-aortic lymphadenopathy and ascites.

Impression:

Complex hypogastric mass, as described, which maybe colonic in origin. CT scan is suggested for further
evaluation.
Hepatomegaly with diffuse steatosis.
Tiny gallbladder polyp.
Consider cystitis.
Unremarkable ultrasound of the biliary tree, pancreas, spleen, kidneys and abdominal aorta.
Normal-sized anteverted uterus.
No evident para-aortic lymphadenopathies and ascites.

CT SCAN of the WHOLE ABDOMEN

11/4/2023
CLINICAL INFORMATION: hypogastric mass
COMPARISON: None
EXAMINATION: Plain and oral contrast axial CT images of the whole abdomen with reconstructed sagittal
and coronal images were obtained.

FINDINGS:

Stomach and bowel: The sigmoid colon is redundant. There is a circumferential, nodular wall thickening in the
sigmoid colon measuring about 10 cm in length with narrowed lumen. Surrounding fat stranding densities are
seen. The small bowel and proximal colon are not dilated.
Peritoneum: An ill-defined heterogeneous mass with pockets of air is detected intimately related to the sigmoid
colon and urinary bladder. It measures about 9.5 × 7.3 x 5.9 cm. Surrounding fat stranding densities are evident.
Appendix: It is unremarkable measuring 0.45 cm in diameter.
Liver: There is diffuse parenchymal hypoattenuation.
Bile ducts: Not dilated.
Gallbladder: No calcified gallstones.
Pancreas, Spleen and Adrenals: No remarkable findings.
Kidneys: The right kidney measures 12.5 x 4.9 x 5.1 cm while the left kidney measures 13.8 × 4.4 x 5.3 cm.
There is a hypodense focus in the superior pole of the right kidney measuring 1.1 × 1.1 cm.
Ureters: Not dilated.
Urinary bladder: It is partially-filled but there is thickening at the anterior and superior wall with luminal air,
Reproductive organs: No focal lesions are seen in the adnexa and uterus,
Lymph nodes: No enlarged mesenteric, retroperitoneal or pelvic lymph nodes.
Vessels: Minimal segmental calcifications are seen in the abdominal aorta and iliac arteries.
Abdominal and pelvic walls: Unremarkable.
Bones: Spurs are seen in the lumbar and included thoracic vertebrae as well as the margins of the pelvic bones.
Included lower chest: Unremarkable.

IMPRESSIONS:

1. Primary consideration is complicated sigmoid diverticulitis with abscess formation extending in the urinary
bladder. Cannot totally exclude sinus/fistula formation. Differential diagnosis is neoplastic process. Please
correlate clinically.
2. Fatty liver.
3. Small hypodense right renal focus, likely cyst.
4. Enlarged left kidney.
5. Mild atherosclerotic vessel disease.
6. Degenerative osseous changes.

Chest PA
11/6/2023
CHEST PA
The lung fields are clear.
The heart is not enlarged.
The costophrenic sulci and diaphragm are intact.
Osteophytes are seen in the thoracic vertebrae.
There is incidental note of round to ovoid, calcifications in the left upper abdomen.

Impression:

NORMAL CHEST FINDINGS

SAVE FOR DEGENERATIVE CHANGES IN THE THORACIC SPINE

INCIDENTAL FINDING OF CALCIFICATIONS IN THE

LEFT UPPER ABDOMEN. CONSIDER STAGHORN CALCULI.
CORRELATION WITH ULTRASOUND IS SUGGESTED.
ECG Sinus rhytms
11/6/2023 Normal ECG
11:34 am