29/M,single,. came with c/o of upper abdominal pain, vomiting 3 days..ch alcoholic. wt 49kg. cvs&other system-no obvious abnormality.. For ur suggestion pls..

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This is a case of chronic male alcoholic with acute cholecystitis due to acute cholelithiasis and splenomegaly and hyperbilirubinemia . Treatment is 1 Stop alcohol immediately. 2 Correct dehydration by intravenous fluids. 3 Correction of electrolytes. 4 IV Antibiotics 5 IV antispamodics. 6 IV anti emetics. 7 IV PPI 8 Last and final option is either laparoscopic or open cholesytecomy.

Pancreas are normal in CT scan abdomen. Obstructive jaundice is due to gall stones. As soon as obstruction is releived by surgery, bilirubin becomes normal. Liver is not effected in this case luckily even though patient is chronic alcoholic.
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obstructive jaundice, cholelithiasis with ALD. R / o pancreatitis. rx accordingly with lap cholecystectomy after jaundice subsided with conservative management. ..

Chronic alcoholism in a 29 year old male? Young male with splenomegaly, gallstones and raised bil.( both types) Normal liver and gall bladder wall on usg abdomen. Alcoholic hepatitis can be one diagnosis but screening for hemolytic anemia and Concurrent Zieves syndrome can be looked for. No pericholecystic fluid, no neck stone, normal TLC, normal gb wall do not suggest acute cholecystitis.

May be alcoholic gastritis start inj .nexium 40mg iv star followed by 40 me by or tds. . sup. ranidom 0 suspension10ml tds. inj. dicyclomine 10th im

Do amylase to rule out alcoholic pancreatitis
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Patient has spleenpmegaly.increase indirect bilirubin.cholelithiasis. Any associared hemoglobinopathy to rule out.

With uch a high S .Bilurubin ideal will be MRCP. have an idea of of the biliary tree. Erap with Stenting to reduce the Jaundice. Wait for 2 - 4 weeks reassess and if every thing has settled down ptroceed with Lap chol . Monitor prothrombin time and other clotting factors before surgery

Please do 1.serum amylase and lipase .2MRCP to r/o pancreatic duct stricture or CBD sludge or distal cbd stricture then ready with either ercp with laparoscopic cholecystectomy or stent it and elective laparoscopic c

sorry typo lap cholecystectomy and stent or no stent only lap cholecystectomy or stent alone with elective laparoscopic cholecystectomy later
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obstructed jaundice with?choledocholithiasis.rule out pancreatitis with serum lipase and plan mrcp if nonconclusive treat symptomatic with Iv fluid and antispasmodic antibiotic

Acute alcoholic gastrities With alcholic hepatities With choleshesis iv antiboitic emset pan eldervit cylopam inj dynapar udilive

A case of Alcoholic hepatitis. CT not showing obstruction. Treat conservative, after bilirubin normal. May be plan Lap. Chole.

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