A male pt aged 55 yrs c/o mild abdominal pain with pedal oedema since more than 2 yrs accompanying with generalised weakness.... Consulted with many physicians n surgeons but no relief..... What is the diagnosis n how to manage no h/o Dm or Ht

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Hi Dr. Prashant, a slightly more detailed history will be helpful for a clinical diagnosis in this case, for example- (1) pitting / non-pitting edema (2) is the edema an intermittent or constant finding (since it has been there for 2 years)- (waxing-waning phenomenon) and does it subside on assuming the supine position (3) Any facial puffiness ? (4) which quadrant(s) is the abdominal pain felt in (describing the nature of pain and its onset, whether radiating or non-radiating and/or whether it is associated with any GI disturbances) (5) Any co-morbidities ? (6) what is his Cardiac Status ? (7) LFT for Total proteins and A:G ratio and Urine Routine, Thyroid status Thank you

Dr Parshuram agarwal I agree in these kind of cases proper history is very important. I will say personal examination is also very important.
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Milroys disease

LYMPH EDEMA DOPPLER ULTRASOUND LOWER LIMB VEINS ALSO ARTERIES RX 1 RAISE LOWER LIMBS 30 ' 3- 4 TIMES DAILY 2 FLUID RESTRICTION I.5 L / DAY ......3 SALT RESTN . 3GM / DAY 4 ELASTIC STOCKINGS INVESTIGATIONS LFT CREATININE T4 TSH COMPLETE HAEMOGRAM USG ABDOMEN URINE MCR

Dear Dr prashant kindly let me know the oedema was progressive in2 yrs and specify the area of abdominal pain.thanks.

Malabsorption syndrome may be a possibility. Fecal fat content and serum proteins needs to be ordered.

congestive cardiac failure e.g. secondary to fluid overload, ischaemic heart disease hypoalbuminaemia e.g. liver disease, malnutrition, nephrotic syndrome

Sir you first need to look out for local causes of bilateral pedal edema e.g. Filaria specially if the pt is from up or Bihar or travelled to these places Does nt seem to be varicose as there is hardly any pigmentation it starts with one leg and also you dint mention it n what about the peripheral pulses Is there a history of smoking , family history of cardiac ailments , lipid profile abdominal usg and Doppler to rule out atherosclerosis Also need to get more information about the pain abdomen and edema But as others have suggested you need to rule out cardiac hepatic or renal causes

MYXEDEMA/CCF/CRF.

? hypothyroidism?is patient tacking CCB for hypertension

pedal oedema may be the sign of liver .kidney or heart infection

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