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Need Suggestion For Emergency Rx & Management. Patient Is In ICU

Patient Age 40 Yrs Old With History of Chronic Alcoholic With Complaint Absent of Urination & Pain Abdomen.Previously History Of Diagnosis With DM & TB.Here Is I Am Attaching Some Of Reports. Please Suggest Further Management. Thank You.

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hi dr kamal.. since ur ptn is in icu so u no need to be worried. atleast he will be away from alcohol.bahut mohabbat ki alcohol se lagta. fine lets get into the case.. reports r suggestive of highly chronic alcoholic fellow where organs anatomical structure has gone into defective stage.lets try to decode this case.. 1]LIVER ::alcoholic induced fatty liver changes.its an reversible injury. doesnt lookalike cirrhosis stage. 2]GB::acute cholecysitis.sludge..here cholecystectomy may required.was bit confused with this suggestion of usg correlation in ct report. 3]BOWEL: though unremarkable but except this localised diffuse pattern of symmetrical thickness at caecum may further be required to evaluate.. 4]PANCREAS:this has been severely affected.alcohol is inciting factor.has converted from acute pancreatitis into chronic pancreatitis stage.thru chronic inflammation to extensive scarring which has lead to obstruction of ductules leads into stasis and calculi..pseudocyst could be complication ??but amylase is elevated seen mostly??so this peripancreatic fat would be required to evaluate.. 5]moderate ascites and pleural effussio right> seen mostly in cirrhosis stages but lets get into this diagnostic paracentesis..would help us in knowing cause. fine.. confusion was with USG readings of pancreas?? u will be required to do more workup in this case from proper case presentation. anuria as suggested looks to be unlikely. go for lab parameters..update the case if possible from icu.dont forget to mention pulse bp. let the consultant take a call and decide treatment line. hope and wish tried my level best to explain this case.

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Multiple organ failure Kco DM2T and p/h of tuberculosis Present status suggest acute on chronic pancreatitis with polyserositis Pleural effusion and ascitis + Fatty liver changes with hepatomegaly in alcoholic needs LFTS As usg suggest abdominal tuberculosis Management is multiaproach Diabetic profile and need to put on OHA Effusion tapping for diagnostic purpose to r/o active tuberculosis Pancreatitis need to be managed by iv antibiotics As oligouria or anurea should be attended by iv fluids in slow infusion +inj lasix

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Alcoholic Cirrhosis of liver with multi organal involvement. Uncontrolled diabetes is in the root of all problem. Pancreatitis...With Ascitis. Taping and investigate the ascitic fluid. HBA1C. Liver Profile. Renal.Profile.. Amylase.P/ Bypass ratio..

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Moderate ascites with chronic calcific pancreatitis It could be pancreatic ascites causes by rupture of pancreatic duct, commonly seen in chronic pancreatitis Adv Ascitic fluid amylase and routine microscopy High ascitic fluid amylase would indicate pancreatic ascites - of it is found, it is treated with pancreatic stenting

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As the reports are showing it may be a case of acute pancreatitis with shock with AKI. pt is not passing urine and also there is ascitis.its all because of serositis.kindly manage shock and refer to surgeon for further management

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K/C/O ..DM WITH.. ? HEPATOMEGALY WITH.. GALL BLADDER PATHOLOGY.. AND .. ASCITES.. COLITIS.. NEED'S.. TO EVALUATE ACCORDINGLY WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

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hi dr kamal.. since ur ptn is in icu so u no need to be worried. atleast he will be away from alcohol.bahut mohabbat ki alcohol se lagta. fine lets get into the case.. reports r suggestive of highly chronic alcoholic fellow where organs anatomical structure has gone into defective stage.lets try to decode this case.. 1]LIVER ::alcoholic induced fatty liver changes.its an reversible injury. doesnt lookalike cirrhosis stage. 2]GB::acute cholecysitis.sludge..here cholecystectomy may required.was bit confused with this suggestion of usg correlation in ct report. 3]BOWEL: though unremarkable but except this localised diffuse pattern of symmetrical thickness at caecum may further be required to evaluate.. 4]PANCREAS:this has been severely affected.alcohol is inciting factor.has converted from acute pancreatitis into chronic pancreatitis stage.thru chronic inflammation to extensive scarring which has lead to obstruction of ductules leads into stasis and calculi..pseudocyst could be complication ??but amylase is elevated seen mostly??so this peripancreatic fat would be required to evaluate.. 5]moderate ascites and pleural effussio right> seen mostly in cirrhosis stages but lets get into this diagnostic paracentesis..would help us in knowing cause. fine.. confusion was with USG readings of pancreas?? u will be required to do more workup in this case from proper case presentation. anuria as suggested looks to be unlikely. go for lab parameters..update the case if possible from icu.dont forget to mention pulse bp. let the consultant take a call and decide treatment line. hope and wish tried my level best to explain this case.

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Liver cirrhosis with Ulcer colitis Chronic alcoholic It would be better to put him on Panchakarma..Shodhana Chikitsa will do him favor, and councelling is most required. you have to be in touch with your client constantly. Shirodhara and thalam are very good in order to calm down the anxiety..It's difficult to control the craving but if you councel him in a proper direction, you can achieve the best result...Good luck

Patient Is In ICU
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Very poor history, on the basis of available history we don't know onset, duration, progression? No examination at all...!!!!!!! Absence of urination can due to retaintion or even due to non production of urine Possibility of Hepatic encephalopathy with hepatorenal syndrome With ? chronic pancreatitis In view of normal amylase and lipase, acute pancreatic is less likely There are no I formation of Urea or creatinine ??

40 YEARS MALE PATIENT CHRONIC ALCOHOLIC PREVIOUS HISTORY OF DM TB HAS RETENSION URINE AND PAIN ABDOMEN D M CAN PREDISPOSE TO URINARY INFECTION PATIENT COULD HAVE PSOSTATE ENLARGEMENT WHICH CAN BE CAUSE OF RETENSION URINE ULTRASOUND TO ABDOMEN AND PROSTATE URINE ANALYSIS UROFLOWMETRY CONSULTATION OF UROLOGIST CATHETERIZATION FOR RERENSION OF URINE

Refer him to surgical gastro..thy wil plan LPJ accordingly.at present put him on creon tablets,udiliv n painkillers ....

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