Known alcoholic shrinkage of rt lobe of liver with ascites Cholelithiasis splenomegaly umbilical hernai do hida scan ascitic tapping cbnat lft rft cbc ESR lipid profile thyroid profile cirrohosis of liver with Cholelithiasis splenomegaly udiliv300 mg bd
pt had liver parenchymal disease with ascites-may be alcoholic liver cirrhosis with phtn,ascites, cholilethesis.investigate the pt lft, rft, bsl, pt inr, electrolytes, cbc, and usg abdomen doppler and sos upper GI scopy for esophageal varices. give udiliv 300 tds,lasilactone or aldactone bd, multivitamin supplements,and symptomatic treat
Hi , with these findings in a patient with significant alcohol intake history , first diagnosis is alcohol related cirrhosis of liver , you also have to exclude hep b and hepatitis c , most important here is abstinence from alcohol , 4 grams salt restriction per day , monitor sr creatinine and Sr electrolytes and according diuretics , please dont overdo treatment as it may result in acute kidney injury .
It's chronic liver disease with portal hypertension with probable coincidental finding of GB calculi...
a case of portal hypertension with liver parenchymal disease, CBC, LFT, amylase, lipase, RFT, CECT, Doppler study-, Endoscopy to r/o varices
you refer this patient to Hepatologist. ..its better for the patient. ..Don't treat the things u r not specialised in...
hlw friends pt. is having only complaint with diarrhoea and enlargement of abdomen... SGPT 90... S.BILIRUBIN-1.7...I advised him to go for HBSAG,S.CREATININE, CBC, URINE and if necessary then advise for endoscopy.
cirrhosis of liver with portal hypertension
agree with Dr Nadeem add inderal 40 1/2 bd and gradually increase dose and if pt has developed hepatic enceph also add rifaximin 550 od with lactulose
with a report of USG abdomen and only h/o taking junk foods, without any clinical findings and routine investigation. .how do you expect somebody to comment on management. ...its simply strange. ..isn't it?
Cases that would interest you
- Login to View the image
Plzz guide. What is the problem nd what should b further treatment ?Akshay Deokar1 Like17 Answers
- Login to View the image
Friends today I am discussing about Hepatitis. Hepatitis Hepatitis is the inflammation of the liver. The most common cause for hepatitis is viruses. Other causes may include excessive alcohol use, certain medications, toxins, other infections, and autoimmune diseases. Types of Hepatitis Hepatitis is mainly of five types that are caused by a virus, A, B, C, D, and E. These can be commonly determined by a laboratory test. Hepatitis types A, C, D, and E is caused by viruses that have a core of ribonucleic acid (RNA). While virus responsible for hepatitis B has a DNA core. Causes of Hepatitis • Hepatitis A and E are mainly spread by contaminated food and water. Hepatitis A is also called infectious hepatitis as it is very highly contagious disease, but it is rarely fatal. • Hepatitis B spreads through sexually transmission, but may also be passed from mother to baby during pregnancy or childbirth. Hepatitis B is also called as viral hepatitis. It can be severe and often leads to liver cirrhosis. Hepatitis B may commonly transmit through transfusions of contaminated blood. • Both hepatitis B and hepatitis C are commonly spread through infected blood like during sharing of the needle by intravenous drug users. Complications of Hepatitis C can lead to chronic hepatitis, cirrhosis, or liver failure. • Hepatitis D can only infect people already infected with hepatitis B. Hepatitis D is the most serious and also the rarest form of viral hepatitis. Many cases of hepatitis D are fatal, and most chronic cases lead to cirrhosis. • Hepatitis E often occurs in epidemics that can be linked to poor hygiene and contaminated water. Pregnant women can be at risk due to infection by Hepatitis E. The disease has been reported almost exclusively in developing countries. Symptoms of hepatitis Many people with hepatitis experience either mild symptoms or none at all. Symptoms may not occur until liver damage occurs. Acute hepatitis - The initial phase of hepatitis is called the acute phase. The symptoms may include: • Diarrhea • Fatigue • Loss of appetite • Mild fever and flu-like symptoms • Muscle or joint aches • Nausea & Vomiting • Pain in abdominal • Unexplained Weight loss. Chronic hepatitis-- The acute phase is not usually dangerous, but it may develop into the fulminant type of hepatitis which is a very serious stage and can lead to death. As the patient gets worse, these symptoms may follow: • Portal Circulation problems • Dark urine • Dizziness & Drowsiness (only toxic/drug-induced hepatitis) • Enlarged spleen (only alcoholic hepatitis) • Headache • Hives with or without Itching of skin • Clay-colored stool, which may contain pus • Yellow skin, whites of eyes, tongue (jaundice). Complications of Hepatitis Fibrosis - One of the most common complications of chronic hepatitis is fibrosis, which is a type of scarring of the liver. Due to constant inflammation, the liver is damaged and creates the scar tissue to repair itself. Cirrhosis of the liver - Extensive fibrosis is called cirrhosis. There are many causes for Liver cirrhosis, but alcoholic hepatitis and Hepatitis C is the common. Cancer of the Liver - One of the complications of cirrhosis is liver cancer, which are usually two types. First is hepatocellular carcinoma, where liver cells are affected. The other type is cholangiolar carcinoma, which affects the bile ducts. Liver Failure - Liver failure is a serious, but uncommon, complication of hepatitis. In this condition, function of the liver stopped and this leads to the body shutting down, and eventually, death. Glomerulonephritis - Glomerulonephritis is a kidney disorder caused by inflammation of nephrons and is seen in chronic hepatitis B and hepatitis C infections. Cryoglobulinemia - Seen in chronic hepatitis B and hepatitis C infection, cryoglobulinemia is an uncommon disease caused by an abnormal cluster of a kind of protein that blocks small blood vessels leading to circulation problems. Hepatic Encephalopathy - Severe loss of liver function, such as liver failure, can lead to inflammation in the brain called encephalopathy. This causes mental problems, like confusion, and can lead to coma. Portal Hypertension - One of the liver's important jobs is to filter blood. When this portal system is blocked due to liver cirrhosis and other problems, blood can't return to the liver from the digestive system and pressure increases. This is called portal hypertension and it is a serious complication and can be fatal. Porphyria - Porphyria is a group of diseases caused by problems processing important chemicals in the body called porphyrins. One type, called porphyria cutanea tara, leads to blistering of the hands and face and is a rare complication of chronic hepatitis C infection. Viral Co-Infection - A challenging complication of hepatitis is the possibility of having two viral infections at the same time. A common with co-infection with hepatitis is the human immunodeficiency virus (HIV). Other common co-infections are with the hepatotropic viruses, named A through E. This type of Co-infections can be fatal. Diagnosis • Complete blood count • Liver function Test • Laboratory test to identify virus in blood • Bleeding time • Clotting time • Imaging- Ultrasonography, CT- scan, MRI • Liver biopsy Homoeopathy in the treatment of Hepatitis and other liver problem Homeopathy provides a very effective and safe treatment for Hepatitis and other liver disorders. It relieves the discoloration of the skin, mucous membrane, and sclera. These medicines strengthen the liver and metabolic system. The aim of homeopathy is not only to treat Hepatitis infection but It works by treating the underlying cause and not just the symptoms. The treatment is gentle and the relief obtained is usually long term. There are many homoeopathic medicines that have the potential to cure Jaundice. Out of them, few are – Andrographis Paniculata - Useful in resistant jaundice. Useful in Hepatitis B and C. It is found useful when Chelidonium Majus does not help. Arsenic Album - Where hepatitis results from bad food or food poisoning, Arsenic Album is the best Homeopathic medicine. There is burning pain in the liver which gets better with warm drinks. Aurum Metallicum - Very effective for jaundice during pregnancy. Distension of epigastrium with increased thirst and appetite, followed by burning sensation and hot eructations. Carduuas Marianus - Carduus Marianus is a very effective remedy for liver cirrhosis with general edema. There is engorged and laterally swollen liver, which gets worse from pressure. Jaundice. Carica Papaya - Hepatomegaly and splenomegaly associated with fever, dyspepsia and indigestion. Constipation is marked feature of this remedy. Intolerance to milk even small amount may lead to pain. Chelidonium - Chelidonium is very effective in treating an enlarged liver with tenderness. Hepatomegaly with bilious complications. Dull, throbbing pain in the region of the liver is also best treated with Chelidonium. Jaundice due to hepatic and gallbladder obstruction. Pain aggravation on eating. Marked desire for hot food and drinks Chionanthus - Chionanthus is very effective in chronic cases of jaundice, which recur every summer. The symptoms include an enlarged liver, constipation, clay-coloured stools and very yellow skin. Crotalus Horridus - Crotalus Horridus is used to treat jaundice cases where the entire body has gone yellow. Pain in the liver, coldness, Constant nausea and vomiting. Jaundice with haemorrhagic manifestations. Atonic dyspepsia. Complications arise from a blood transfusion. Lachesis - Lachesis is very effective for liver complaints largely among alcoholics. In cases where the liver region is very sensitive and a person can’t bear anything around the waist, Lachesis is one of the most effective Homeopathic medicines for fatty liver. Sensitiveness of right hypochondrium, hazards of blood transfusion. Lycopodium - Hepatitis, the atrophic form of nutmeg liver. Shooting pain across lower abdomen from right to left. Excessive flatulence. Bread aggravates. The desire for sweet and warm things. Natrum Sulpuricum - Natrum Sulphuricum is one of the great Homeopathic medicines for liver problems like jaundice where the symptoms include a liver region that is sensitive, tender and sore to the touch. Vomiting bile is another indicator. Nux Vomica - Hepatitis associated with constipation. Liver enlarged with stitches and soreness. Alcoholic liver. Phosphorus - Acute hepatitis. Fatty degeneration of liver, cirrhosis, and jaundice associated with the pancreatic disease. Suppuration with hectic night sweats, enlargement, and marked soreness. Podophyllum - Chronic relapsing hepatitis. History of repeated jaundice. Pain in right hypochondrium. Not well since the first attack of hepatitis. Irritable temperament with suicidal tendency.Dr. Rajesh Gupta4 Likes14 Answers
- Login to View the image
A chronic alcoholic presented to ED with complaints of Grossly distended abdonen, Pain Rt hypochondrium and black coloured stools since 10 days....On investigating, he was found to be HBsAg reactive....MRCP was done...Comment on the treatment and approach to this patientDr. Hardik Ahuja0 Like11 Answers
- Login to View the image
30yr F h/o hematemesis ,hematochezia, now came with c/o gen.weakness ,abo.distention her Hb-3.0,RBC-1.94,WBC-2500,plt-76000. Usg of abd-fatty liver ,splenomegaly,mod.ascites 16mm gall stone.. XRC-normall wht is d/d ? wht :tretment can?plz replyDr. Vijay Waje0 Like28 Answers
- Login to View the image
A chronic Alcoholic male aged 54 yrs presented with complaints of Malaena (on/off), abdominal distension, decreased urine output since 15 days and Altered Sensorium since 1 day.... He was found to be in Shock at presentation and was put on intropic support... comment on his condition and treatment approach to this patient...Dr. Hardik Ahuja4 Likes26 Answers