Dr. Ashutosh Chandan Dubey (Internal Medicine) needs a second opinion on this medical case.
Decompensated cirrhosis of liver -Alcohol induced with portal HTN, Ascites and UGI Bleed ( Esophageal varices with portal hypertensive gastropathy)
A 50 yr old male has come with complains of 1 episode of bloody vomitus and abdominal distension.
No associated yellowish discoloration of urine, pruritus, pain in rt hypochondrium, altered sensorium, reversal of sleep wake cycle, malena etc.
He is a chronic Alcoholic.
No H/O HTN, T2DM, Hypothyroidism etc.
P/A - abdomen is distended, with everted umblicus, flanks are full , slight visible veins over abdomen, no organomegaly.
Loss of chest and axillary, pubic hairs, hepatic faices with icterus and malar prominence, no parotid enlargement, no Duptyren s contracture, no flapping tremor.
No features of Hepatic encephalopathy, platypnea etc.
Blood reports showing raised Sr bilirubin, ALT and AST. Normal PT/INR.
USG W/A showing features of cirrhosis and renal calculus with Ascites.
Pt reported today 1 more episode of hematemesis and 3 episodes of malena.
UGI endoscopy was done showing 3 column, grade 2 varices and PHG. Variceal banding was done.