WHAT'S THE THE TREATMENT AND MANAGEMENT?

A 40 year's old male labour came with c/o abdomen pain with his USG report. Chief Complaints Abdomen pain History Pain from one year. Vitals Stable Physical Examination Abdomen tenderness Investigations USG If any essential investigation please suggest. Diagnosis ???? Management Please suggest???

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Pain in Abdomen is very important symptom Proper history itself many times clinches the diagnosis Without proper history, all other investigation may not be able to reach to a conclusion Following are important when one describes pain in Abdomen Location of pain Based in quadrants of Abdomen, Quality of pain - continuous or colicky type - in colicky pain intensity of pain increases and decreases Intensity of pain - mild moderate severe Aggravating or relieving factor - example - the pain of acid peptic disease and intestinal obstruction is aggravated by food intake, pain of pancreatitis is relieved by bending forward, Radiation of pain - renal colicky pain radiate from loin to groin These characteristics of pain need to be described meticulously, they point to diagnosis and underlying pathology

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Multi organ disease any h/o addiction As pt has hepatosplenomegaly as well as cholecystitis and hypoechoic pancreas Hence better evaluate the case Adv cbc esr LFTS KFTS Sr amylase Ct abdomen Hypoechoic pancreas raises suspicion Fatty liver disease with dialated gallbladder Appears there is extrabilliary compression Likely periportal lesion

Thanx dr Kute Ankush
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HEPATOMEGALY.. DISTENDED GALLBLADDER.. MILD SPLEENOMEGALY.. NEED'S .. BLOOD CBC LFT..KFT.. CHOLANGIOGRAPHY.. CTCE STUDY..ABDOMEN..

Tnx Dr Vipin Bihari Jain sir
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Ultrasound abdomen findings are Hepatosplenomegaly with fatty liver. Distended gall bladder . Hyperechoic pancreas, which is a type of fatty infiltration of pancreas. This is usually associated hyperlipidemia, increased waist circumstance and metabolic syndrome. Suggest Check BMI , lipids , BP , fibroscan of liver , serum insulin, diabetic profile.

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USG finding does not support any cause for pain abdomen. Pain abdomen is a vast entity ,so history and clinical examination and findings playn a great role for diagnosis provisionally. You are to examine the abdomen quatrants wise to look for pathology of the organs quadrants wise. History like pain any relation with food, any radiation . Bowel and bowel habit etc etc.ABDMEN IS APANDORAS BOX.

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Hepatomegaly with fatty liver Splenomegaly Distended Gallbladder

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Chronic hepatosplenomegaly Needs further evaluation

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CBC, ESR, LFT serum Lipase and Amylase. TFT, HbA1c..Review with report. Exercise, low fat diet.

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PT need s CBC Left Cholengography Also decide to consult gastro enterologist

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