hepatic abscess spleenomegaly
15 years male patient Treatment..?? Chief Complaints Fever and headache from last 10 days Pain in abdomen and anorexia from last 2 days Usg whole abdomen done.
Hepatic abscess rt lobe with thick walled A/w fever most likely AMOEBIC ABSCESS FATTYLIVER Splenomegaly and celiac lymphadenopathy needs to workout out Adv aspiration of abscess and send for analysis Adv ct abdomen Cbc esr bsl urine and stool examination
It is a large size - 90× 85 mm abscess in liver - it requires CT guided drainage of abscess - most likely a PYOGENIC Abscess but could be amoebic abscess . Post drainage of abscess following treatment is indicated 1.Inj Cefriaxone 1 gm + sulbactum 500 mg B.D I/V for 10 days,followed by tab cefuroxime 500 mg + clavulanic acid B.D for 2 weeks . Also tab metronidazole 400 mg T.D.S for 2 weeks
Do, CBC & ESR, LFT, HbsAg, HCV, LDH, PTINR, APTT, Liver Spleen Colloidal Scanning, EUS, PLAN FOR SPLENECTOMY,, CONSULT GIT SURG.
?? Pyogenic abscess ?? Amoebic liver abscess USG/CT guided drainage of abscess, Pus sent for culture and sensitivity, Send CBC,LFT,RFT, Antibiotics depends upon the culture sensitivity, Antipyretics. CT abdomen should be done incase of recurrent abscess.
Need CT abdomen and CT guided aspiration of liver abscess. DD Amoebic liver abscess. - ankovy sause pus . Pyogenic abscess Infected hytadid cyst Treatment according to diagnosis
? HERPETIC ABSCESS.. WITH..ASSOCIATED COMPLICATIONS..
The first line treatment in uncomplicated amebic abscess should be amebicidialdrugs. Metronidazole is the drug of choice and has replaced the use of NJ emetine andchloroquine. Metronidazole is effective against both the intestinal and hepatic phase. 750 mg three times a day for 7–10 days is recommended....... Drainage tubal infection !!!!
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my very close relative who r suffering hypertrophy of kydney WD renal calculi,mild spleeno megaly and fatty liver disease.... and he donated his kydney 7 yrs back his mother....few day s back I had send dis case profile for discussion..... finally his relative decided to refer to secundrabad yashoda hospital for better TT and solution..... (Dr.c h rajendra prasad who r nephrologist and kydney transplant physian ) in yashoda hospital and he had handled dis case...he rule out all investigation ...but he didn't say abt renal calculi in lower pole of kydney and didnt informed his relatives who r already mentioned in USG report....and he said everything is OK and prescribed so many caustle medicine ---1.ALPHA KETANOLOUGE TAB 1 BD 2.PRE -PROBIOTIC CAP 1_TDS. BUT problem is not subsided...creatinine level again high in condition(1.5) and uric acid slight grow in level. actually pt belong from Allahabad..... finally he consult d local nephrologists Dr ...and Dr looked all reports and prescriptions of yashoda hospital and he s awake....and he said to his relative... pt suffering 6mm calculi in lower pole of kydney ...and he said why prescribed dis medicine? Again pt admitted in local hospital for taking TT....pt now quite stable..abhi b pt Allahabad k hospital me admitted hai...jo Dr Saab ek injection prescribed kiya hai DRUNEM-1 INJ..jiski price 1200 rs hai ji morning evening lag raha hai aur Jo pichle hafte se lag raha hai. Dr Saab se pucha hu to WO kahte infection k liye hai uske control hone k baad stone nikala jayega.......Dr Saab to apne jagah sai hai par pt k relative panic me hai aur kispe viswas kare aur naa kare aisi sthiti ab bangayi hai. pt already spent 90000rs in cash in yashoda hospital( secundrabad)... only just 3 days for admission? but I want d ask one questions to all curofians...why r making buisness and playing so many lifes ,?. kisi k life just a body kar k treat karna ab shayad trend as ban gaya hai? ...shayad aise doctoro wajah se pure doctoro ko shak k nazar se b dekha jaata hai.....aur aye din doctoro k saath jo violence hone ki khabre aati hai ye aise doctoro kartut k wajah se hota....? respected drs plz share ur views on dis case.
Dr. P. G. Shah0 Like14 Answers - Login to View the image
Role of Homoeopathy in the treatment of Hepatitis and other liver problem Homeopathy provides a very effective and safe treatment for Hepatitis and other liver disorders. It relieves the discoloration of the skin, mucous membrane, and sclera. These medicines strengthen the liver and metabolic system. The aim of homeopathy is not only to treat Hepatitis infection but It works by treating the underlying cause and not just the symptoms. The treatment is gentle and the relief obtained is usually long term. There are many homoeopathic medicines that have the potential to cure Jaundice. Out of them, few are – Andrographis Paniculata - Useful in resistant jaundice. Useful in Hepatitis B and C. It is found useful when Chelidonium Majus does not help. Arsenic Album - Where hepatitis results from bad food or food poisoning, Arsenic Album is the best Homeopathic medicine. There is burning pain in the liver which gets better with warm drinks. Aurum Metallicum - Very effective for jaundice during pregnancy. Distension of epigastrium with increased thirst and appetite, followed by burning sensation and hot eructations. Carduuas Marianus - Carduus Marianus is a very effective remedy for liver cirrhosis with general edema. There is engorged and laterally swollen liver, which gets worse from pressure. Jaundice. Carica Papaya - Hepatomegaly and splenomegaly associated with fever, dyspepsia and indigestion. Constipation is marked feature of this remedy. Intolerance to milk even small amount may lead to pain. Chelidonium - Chelidonium is very effective in treating an enlarged liver with tenderness. Hepatomegaly with bilious complications. Dull, throbbing pain in the region of the liver is also best treated with Chelidonium. Jaundice due to hepatic and gallbladder obstruction. Pain aggravation on eating. Marked desire for hot food and drinks Chionanthus - Chionanthus is very effective in chronic cases of jaundice, which recur every summer. The symptoms include an enlarged liver, constipation, clay-coloured stools and very yellow skin. Crotalus Horridus - Crotalus Horridus is used to treat jaundice cases where the entire body has gone yellow. Pain in the liver, coldness, Constant nausea and vomiting. Jaundice with haemorrhagic manifestations. Atonic dyspepsia. Complications arise from a blood transfusion. Lachesis - Lachesis is very effective for liver complaints largely among alcoholics. In cases where the liver region is very sensitive and a person can’t bear anything around the waist, Lachesis is one of the most effective Homeopathic medicines for fatty liver. Sensitiveness of right hypochondrium, hazards of blood transfusion. Lycopodium - Hepatitis, the atrophic form of nutmeg liver. Shooting pain across lower abdomen from right to left. Excessive flatulence. Bread aggravates. The desire for sweet and warm things. Natrum Sulpuricum - Natrum Sulphuricum is one of the great Homeopathic medicines for liver problems like jaundice where the symptoms include a liver region that is sensitive, tender and sore to the touch. Vomiting bile is another indicator. Nux Vomica - Hepatitis associated with constipation. Liver enlarged with stitches and soreness. Alcoholic liver. Phosphorus - Acute hepatitis. Fatty degeneration of liver, cirrhosis, and jaundice associated with the pancreatic disease. Suppuration with hectic night sweats, enlargement, and marked soreness. Podophyllum - Chronic relapsing hepatitis. History of repeated jaundice. Pain in right hypochondrium. Not well since the first attack of hepatitis. Irritable temperament with suicidal tendency.
Dr. Satnam Singh10 Likes14 Answers - Login to View the image
Friends today I am discussing about Hepatitis. Hepatitis Hepatitis is the inflammation of the liver. The most common cause for hepatitis is viruses. Other causes may include excessive alcohol use, certain medications, toxins, other infections, and autoimmune diseases. Types of Hepatitis Hepatitis is mainly of five types that are caused by a virus, A, B, C, D, and E. These can be commonly determined by a laboratory test. Hepatitis types A, C, D, and E is caused by viruses that have a core of ribonucleic acid (RNA). While virus responsible for hepatitis B has a DNA core. Causes of Hepatitis • Hepatitis A and E are mainly spread by contaminated food and water. Hepatitis A is also called infectious hepatitis as it is very highly contagious disease, but it is rarely fatal. • Hepatitis B spreads through sexually transmission, but may also be passed from mother to baby during pregnancy or childbirth. Hepatitis B is also called as viral hepatitis. It can be severe and often leads to liver cirrhosis. Hepatitis B may commonly transmit through transfusions of contaminated blood. • Both hepatitis B and hepatitis C are commonly spread through infected blood like during sharing of the needle by intravenous drug users. Complications of Hepatitis C can lead to chronic hepatitis, cirrhosis, or liver failure. • Hepatitis D can only infect people already infected with hepatitis B. Hepatitis D is the most serious and also the rarest form of viral hepatitis. Many cases of hepatitis D are fatal, and most chronic cases lead to cirrhosis. • Hepatitis E often occurs in epidemics that can be linked to poor hygiene and contaminated water. Pregnant women can be at risk due to infection by Hepatitis E. The disease has been reported almost exclusively in developing countries. Symptoms of hepatitis Many people with hepatitis experience either mild symptoms or none at all. Symptoms may not occur until liver damage occurs. Acute hepatitis - The initial phase of hepatitis is called the acute phase. The symptoms may include: • Diarrhea • Fatigue • Loss of appetite • Mild fever and flu-like symptoms • Muscle or joint aches • Nausea & Vomiting • Pain in abdominal • Unexplained Weight loss. Chronic hepatitis-- The acute phase is not usually dangerous, but it may develop into the fulminant type of hepatitis which is a very serious stage and can lead to death. As the patient gets worse, these symptoms may follow: • Portal Circulation problems • Dark urine • Dizziness & Drowsiness (only toxic/drug-induced hepatitis) • Enlarged spleen (only alcoholic hepatitis) • Headache • Hives with or without Itching of skin • Clay-colored stool, which may contain pus • Yellow skin, whites of eyes, tongue (jaundice). Complications of Hepatitis Fibrosis - One of the most common complications of chronic hepatitis is fibrosis, which is a type of scarring of the liver. Due to constant inflammation, the liver is damaged and creates the scar tissue to repair itself. Cirrhosis of the liver - Extensive fibrosis is called cirrhosis. There are many causes for Liver cirrhosis, but alcoholic hepatitis and Hepatitis C is the common. Cancer of the Liver - One of the complications of cirrhosis is liver cancer, which are usually two types. First is hepatocellular carcinoma, where liver cells are affected. The other type is cholangiolar carcinoma, which affects the bile ducts. Liver Failure - Liver failure is a serious, but uncommon, complication of hepatitis. In this condition, function of the liver stopped and this leads to the body shutting down, and eventually, death. Glomerulonephritis - Glomerulonephritis is a kidney disorder caused by inflammation of nephrons and is seen in chronic hepatitis B and hepatitis C infections. Cryoglobulinemia - Seen in chronic hepatitis B and hepatitis C infection, cryoglobulinemia is an uncommon disease caused by an abnormal cluster of a kind of protein that blocks small blood vessels leading to circulation problems. Hepatic Encephalopathy - Severe loss of liver function, such as liver failure, can lead to inflammation in the brain called encephalopathy. This causes mental problems, like confusion, and can lead to coma. Portal Hypertension - One of the liver's important jobs is to filter blood. When this portal system is blocked due to liver cirrhosis and other problems, blood can't return to the liver from the digestive system and pressure increases. This is called portal hypertension and it is a serious complication and can be fatal. Porphyria - Porphyria is a group of diseases caused by problems processing important chemicals in the body called porphyrins. One type, called porphyria cutanea tara, leads to blistering of the hands and face and is a rare complication of chronic hepatitis C infection. Viral Co-Infection - A challenging complication of hepatitis is the possibility of having two viral infections at the same time. A common with co-infection with hepatitis is the human immunodeficiency virus (HIV). Other common co-infections are with the hepatotropic viruses, named A through E. This type of Co-infections can be fatal. Diagnosis • Complete blood count • Liver function Test • Laboratory test to identify virus in blood • Bleeding time • Clotting time • Imaging- Ultrasonography, CT- scan, MRI • Liver biopsy Homoeopathy in the treatment of Hepatitis and other liver problem Homeopathy provides a very effective and safe treatment for Hepatitis and other liver disorders. It relieves the discoloration of the skin, mucous membrane, and sclera. These medicines strengthen the liver and metabolic system. The aim of homeopathy is not only to treat Hepatitis infection but It works by treating the underlying cause and not just the symptoms. The treatment is gentle and the relief obtained is usually long term. There are many homoeopathic medicines that have the potential to cure Jaundice. Out of them, few are – Andrographis Paniculata - Useful in resistant jaundice. Useful in Hepatitis B and C. It is found useful when Chelidonium Majus does not help. Arsenic Album - Where hepatitis results from bad food or food poisoning, Arsenic Album is the best Homeopathic medicine. There is burning pain in the liver which gets better with warm drinks. Aurum Metallicum - Very effective for jaundice during pregnancy. Distension of epigastrium with increased thirst and appetite, followed by burning sensation and hot eructations. Carduuas Marianus - Carduus Marianus is a very effective remedy for liver cirrhosis with general edema. There is engorged and laterally swollen liver, which gets worse from pressure. Jaundice. Carica Papaya - Hepatomegaly and splenomegaly associated with fever, dyspepsia and indigestion. Constipation is marked feature of this remedy. Intolerance to milk even small amount may lead to pain. Chelidonium - Chelidonium is very effective in treating an enlarged liver with tenderness. Hepatomegaly with bilious complications. Dull, throbbing pain in the region of the liver is also best treated with Chelidonium. Jaundice due to hepatic and gallbladder obstruction. Pain aggravation on eating. Marked desire for hot food and drinks Chionanthus - Chionanthus is very effective in chronic cases of jaundice, which recur every summer. The symptoms include an enlarged liver, constipation, clay-coloured stools and very yellow skin. Crotalus Horridus - Crotalus Horridus is used to treat jaundice cases where the entire body has gone yellow. Pain in the liver, coldness, Constant nausea and vomiting. Jaundice with haemorrhagic manifestations. Atonic dyspepsia. Complications arise from a blood transfusion. Lachesis - Lachesis is very effective for liver complaints largely among alcoholics. In cases where the liver region is very sensitive and a person can’t bear anything around the waist, Lachesis is one of the most effective Homeopathic medicines for fatty liver. Sensitiveness of right hypochondrium, hazards of blood transfusion. Lycopodium - Hepatitis, the atrophic form of nutmeg liver. Shooting pain across lower abdomen from right to left. Excessive flatulence. Bread aggravates. The desire for sweet and warm things. Natrum Sulpuricum - Natrum Sulphuricum is one of the great Homeopathic medicines for liver problems like jaundice where the symptoms include a liver region that is sensitive, tender and sore to the touch. Vomiting bile is another indicator. Nux Vomica - Hepatitis associated with constipation. Liver enlarged with stitches and soreness. Alcoholic liver. Phosphorus - Acute hepatitis. Fatty degeneration of liver, cirrhosis, and jaundice associated with the pancreatic disease. Suppuration with hectic night sweats, enlargement, and marked soreness. Podophyllum - Chronic relapsing hepatitis. History of repeated jaundice. Pain in right hypochondrium. Not well since the first attack of hepatitis. Irritable temperament with suicidal tendency.
Dr. Rajesh Gupta4 Likes8 Answers - Login to View the image
40 yr old male pt comes with h/o fever since 10 days. USG - moderate splenomegaly. Plt count - 87000. How to approach this cas ?
Dr. Amith Gupta2 Likes15 Answers - Login to View the image
30yr F h/o hematemesis ,hematochezia, now came with c/o gen.weakness ,abo.distention her Hb-3.0,RBC-1.94,WBC-2500,plt-76000. Usg of abd-fatty liver ,splenomegaly,mod.ascites 16mm gall stone.. XRC-normall wht is d/d ? wht :tretment can?plz reply
Dr. Vijay Waje0 Like28 Answers
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