27 yr female c/o abdominal distension, generalised swelling,indigestion vomiting rt sided chest pain since 1 month. ur comments on the case pls!!! (amylase 227)

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Clinical and laboratory picture can be corelated with viral hemmhoragic fever like Dengue, Leptospirosis.. Here reactive effusion and ascites is quite common with indirect hyperbilirubinemia and mild transaminitis... Only odd finding is raised WBC. Rule out other source of infection also...

? MODS following SIRS /Sepsis Advice..... 1. Ascitic fluid for SAAG, Protein, LDH, Malignant cells, ZN staining, Cell type, Cell count. 2. Blood for Creatinine, Lipase, Viral hepatitis panel, ANA. Presumptively treat with Lasilactone, Metronidazole, Co Amoxyclav, Symptomatic managements till the reports come.

Please update the case sir
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There is Right lung consolidation with b/l pleural effusion .....most common cause of b/l effusion is CHF...but here no history is given... She needs a thorough evaluation... Do serum Procalcitonin (rule out Sepsis) Ascitic and pleural diagnostic tap... No history of fever is given and abdominal diatension is since 1 month....do 2d Echo and rule out HF

Most likely it's case of chronic hepatitis c pancreatitis do viral hepatitis profile, crp, kft , esr, CT abd .....pl.effusion is secondary to hepatocellular jaundice or pancreatitis.

Hepatocellular Jaundice c Pancreatitis c B/L Pleural Effusion (non TB) c Megablastic Anaemia c Sepsis

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Effusion most likey due to pancreatitis vs synpneumonic effusion with sepsis

Get done viral markers for hepatitis as a b c e Supportive treatment Albumin Diuretic Sos CT Gastro opinion

Pancreatitis with hepatocellular juandice Pleural effusion due to pancreatitis

Pancreatitis with Hepatocellular jaundice.

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