36 YR OLD MALE CAME WITH COMPLAINTS OF YELLOWISH DISCOLORATION OF EYE AND URINE SINCE 3 MONTHS

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Chief complaints:-

36 yr old male who is cook by occupation and came to the hospital with chief complaints of yellowish discoloration of eye and urine since 3 months.

HOPI:-

patient was apparently normal 1 year back ,then he developed lower back ache ,diagnosed with renal calculi and was operated.

C/o fever since 3 months which is Insidious in onset and Gradually progressive , Subsides on its own More during nights. C /o nausea since 3 months

C/o vomitings ( 4 -5 episodes) food particles as content

H/o weight loss since 1month

C/o pain abdomen intermittently and was admitted in an hospital thrice till now and diagnosed with chronic pancreatitis

H/o usage of Herbal medicine 1 month back .

H/o pedal edema and abdominal distension 1 month back , used medication and reduced on using medication.

Past history:-

He is a known case of alcoholic and tobacco chewers since 20 years 

Drinks 750 ml alcohol per day.

H/o Renal caliculi and was operated for that .

There is h/o Tuberculosis in 2012 and used medication for that. 

No h/o diabetes , hypertension,epilepsy,asthma.

Family history:-Not significant

Personal history:-

Thin built

Appetite lost

Regular alcoholic and tobacco chewer,Stopped 3 months back

Bowel movements are Regular.

Urine is high yellow colored .

GENERAL EXAMINATION:-

ICTERUS present

NO PALLOR, CYANOSIS,CLUBBING, LYMPHADENOPATHY,EDEMA. 

Patient is conscious, coherent, cooperative

Temperature : 98.5°f

BP: 80/60mmhg

PR: 99bpm

RR: 18CPM

SPO2: 99@room air

CVS:S1S2+ no murmurs

RS: NVBS+ clear

PER ABDOMEN:

INSPECTION: scaphoid abdomen, umbilicus inverted,no engorged veins,no sinuses

PALPATION: There is local raise of temperature and tenderness present at the right and left hypochondrium ,and epigastric region.

LIVER PALPABLE , no palpable mass .

PERCUSSION:Hepatomegaly + ,LIVER span 20cm.

AUSCULTATION: Bowel sounds +

INVESTIGATIONS

DIAGNOSIS: ACUTE DECOMPENSATED LIVER DISEASE