A 53 year old male came to the GM OPD with 

C/o 

Yellowish Discolouration of eyes since 1 month

Abdominal Distension since 20 days

Pedal Edema since 20 days

Loss of appetite since 10 days

Cough, Fever since 5 days

History of Present Illness

Patient was apparently alright 1 month back then he had yellowish discolouration of eyes gradually progressive.

Abdominal Distension since 20 days, insidious in onset, gradually progressive.

Pedal edema since 20 days, pitting type upto knee

Fever since 5 days, low grade, more at night and associated with dry cough.

No h/o blood in stools, haemetemesis, abdominal pain

No h/o SOB, chest pain, palpitations

Past History:

N/k/c/o DM2, HTN, TB, Epilepsy, CVA, CAD

Personal History 

Appetite-Normal

Diet- Mixed

Bowel& Bladder - Mixed

Sleep- Adequate

Alcoholic since 40 yrs 90ml /day stopped 2months back

10 cigarettes/day for a year and stopped smoking 1 year back

On Examination 

Patient C/CC

No Pallor, cyanosis, clubbing, lymphadenopathy 

Icterus Present

Bilateral Pedal Edema Present

Vitals

Temp- Afebrile

PR-92bpm

BP-100/70 mmhg

RR-19cpm

Systemic Examination 

CVS- S1 S2 +

CNS- NFND

 RS- BAE +

P/A- Distension+

Shifting Dullness+

Fluid Thrill absent

Clinical Images










Diagnosis-

Chronic Liver Disease

Treatment- 

Tab. Furosemide + Aldactone 40/50 PO/OD

Tab. Riifaximin 550 mg PO/OD

Tab. Ursodepxycholic acid 300 mg PO/BD

Syp. Lactulose 15 ml PO/OD

Syp. L-Ornithine L-Aspartate PO/OD

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