46M with ascites and portal hypertension

- April 03, 2021

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46 year old Man, cook by occupation presented with cheif complaints of Abdominal distension, Shortness of breath, pedal edema since 15 days.

Patient was apparently normal 20years back, when he started drinking with friends initially as a recreation, drinks 180ml of whiskey per day, eventually progressed to 360ml per day since 20years. History of smoking of 10 beedis per day since 20 years.

3 years back patient reported history of Alcohol binge following which he developed blood vomiting (?hematemesis) which was subsided after some local hospital treatment.

6 months back after a binge of alcohol he had history of yellowish discoloration of sclera and urine, Abdominal distension, blood vomiting for which they admitted in nearest medical center and told he had jaundice and some liver problem with minimal fluid in abdomen, for which he was prescribed ? diuretics

15-20 days back patient had history of abdominal distension, pedal edema, blood vomiting(passage of dark coloured blood with clots) then he was admitted in local hospital and told that he had Jaundice, anemia (Hb 6gm/dl) and liver problem.

Now presented with Grade 3 Shortness of breath, Gross distension of abdomen, visible veins over abdomen.

N/K/C/O HTN,DM,BA,TB

O/E :

Pt C/C/C

BP 140/70mmhg

PR 100bpm

RR 16cpm

Temp 98.6F

Grbs : 109 mg/dl

Weight 57kgs

Abdomen girth 89cms

Asterxis absent