Presented by 3rd semester Prodymna Kundu)
A 42 year old man admitted to the hospital presents with complaints of
A 42 year old man admitted to the hospital presents with complaints of
• Pain in the abdomen
He had severe pain radiating downwards and laterally from the tip of xiphoid process. The pain is centered mostly around the epigastric and umbilical regions. It had a sudden onset. Pinching sensation. Coughing aggrevates the pain. When perspiring the patient felt giddiness. Nausea present. Episodes of vomiting were there. Before admission he was administered analgesics. Appetite is there but there is a feeling of anorexia. Increased chromacity of urine.
He
had an anal fistula 8 years back.
He has trunkal obesity.
The patient is diabetic (DM -2 )for the last
6 years. Non Insulin taker.
Blood pressure normal
TB, Epilepsy, Asthma - Negative
No surgical history
Mixed diet
Regular and adequate sleep
Irregular bowel and bladder movement (no stool passed for 3 days)
Appetite is normal
Addicted to smoking( 7 no per day )
No history of blood transfusion.
Appetite is normal
Addicted to smoking( 7 no per day )
No history of blood transfusion.
OBJECTIVE
Abdominal Inspection:
Clinical examination for Ascites:
Abdominal X ray:
Amylase 774
Lipase 4632
Lipase 4632
CECT Abdomen:
Serum potassium 3.4
Serum sodium 134
Serum chloride 99
Serum calcium 7.4
Total bilirubin 1.2
Albumin:Globulin 1.7 :1
SGOT 39
SGPT 117
GGT 430
ALP 123
Cholesterol 110
Triglycerides 99
HDL 25
LDL 69
Conversational Clinical decision support:
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