Concluded Case

Abdominal distension.

A 60 yes old male patient come C/o abdominal distension urine pass normally. And stool not pass clear since last 5-6 days... Severe abdominal pain. BP. 90/60mm of HG. Pulse. 90/Mt. Tem.. normal. Spo2. 98% Tenderness++ Chest. Clear... Consciousness. ++. K/C/0. DM 2, Tenderness ++ Ascites. fluid aspreted. 400ml.

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Concluded answer

Dig. clear of patient Abdominal Koch's..

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Ascites with tenderness ? Primary bacterial peritonitis ? Secondary bacterial peritonitis Analysis of ascitic fluid will give lot of information and a clue to diagnosis

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Ascitis noted on CT scan. Possibly peritonitis. Needs to do fluid analysis considering primary cause like liver, pancreatic or renal, origin. Also needs to consider perforative peritonitis. At present hemodynamic stability to be achieved. Fluid and ionotropic support Antibiotics etc.

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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60 YEARS BOKD MAKE WITH ABDOMINAL DISTENSION CONSTAPATION SINCE 5 TO 6 DAYS USG ABDOMEN TO RULE IUT INTESTINAL OBSTRUCTION

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TLC is raised, with tenderness abdomen with ascites. May a case of peritonitis and may be perforation. Adv ultrasound abdomen Admit the patient Nil orally. High antibiotics

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Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection. There are two types of peritonitis: Spontaneous bacterial peritonitis. Sometimes, peritonitis develops as a complication of liver disease, such as cirrhosis, or of kidney disease. Secondary peritonitis. Peritonitis can result from rupture (perforation) in your abdomen, or as a complication of other medical conditions. Peritonitis requires prompt medical attention to fight the infection and, if necessary, to treat any underlying medical conditions. Peritonitis treatment usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body. A common cause of peritonitis is peritoneal dialysis therapy. If you're receiving peritoneal dialysis therapy, you can help prevent peritonitis by following good hygiene before, during and after dialysis Symptoms Signs and symptoms of peritonitis include: Abdominal pain or tenderness Bloating or a feeling of fullness in your abdomen Fever Nausea and vomiting Loss of appetite Diarrhea Low urine output Thirst Inability to pass stool or gas Fatigue Confusion If you're receiving peritoneal dialysis, peritonitis symptoms may also include: Cloudy dialysis fluid White flecks, strands or clumps (fibrin) in the dialysis fluid Causes Infection of the peritoneum can happen for a variety of reasons. In most cases, the cause is a rupture (perforation) within the abdominal wall. Though it's rare, the condition can develop without an abdominal rupture. Common causes of ruptures that lead to peritonitis include: Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis may also develop as a complication of gastrointestinal surgery, the use of feeding tubes, or a procedure to withdraw fluid from your abdomen, and rarely as a complication of a colonoscopy or endoscopy. A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract. Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spreads outside the pancreas. Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulosis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity. Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum. Peritonitis that develops without an abdominal rupture (spontaneous bacterial peritonitis) is usually a complication of liver disease, such as cirrhosis. Advanced cirrhosis causes a large amount of fluid buildup in your abdominal cavity. That fluid buildup is susceptible to bacterial infection. Prevention Often, peritonitis associated with peritoneal dialysis is caused by germs around the tube (catheter). If you're receiving peritoneal dialysis, take the following steps to prevent peritonitis: Wash your hands, including underneath your fingernails and between your fingers, before touching the catheter. Clean the skin around the catheter with an antiseptic every day. Store your supplies in a sanitary area. Wear a surgical mask during your dialysis fluid exchanges. Talk with your dialysis care team about proper care for your peritoneal dialysis catheter. If you've had peritonitis before or if you have peritoneal fluid buildup due to a medical condition such as liver cirrhosis, your doctor may prescribe antibiotics to prevent peritonitis. If you're taking a proton pump inhibitor.

Sub Acute Intestinal obstruction Peritonitis

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Ascitis Tapping cbnat Find out cause Xray chest lft rft Enteroscope

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PT is of protonitis with ascitis Do USG abdomen RFT LFT MOUNTEX FLOUD ANALYSIS

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5-6 days constipation with WBC count 40300 increase ? peritonitis... ? Large intestine obstruction... RxEmergency laparotomy

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