45 YR OLD MALE WITH ABDOMINAL PAIN
202416614 narasimha
CASE HISTORY AND CLINICAL FINDINGS
CHEIF COMPLAINTS :
PATIENT PRESENTED WITH COMPLAINTS OF ABDOMINAL PAIN SINCE 1 DAY.
HOPI
PATIENT WAS APPARENTLY ASYMPTOMATIC 1 DAY BACK WHEN HE DEVELOPED PAIN IN
THE RIGHT UPPER ABDOMEN WHICH INITALLY STARTED AFTER CONSUMPATION OF
TODDY EARLY IN THE MORNING . PAIN IS SQUEEZING IN NATURE, NON RADIATING, NO
AGGRAVATING AND RELIVELING FACTORS.
H/O ANOREXIA SINCE 1 DAY
H/O VOMITIMG 1 EPISODE TODAY
NO H/O FEVER , TRAUMA , DIARRHOEA
NO H/O CHEST PAIN, CHEST TIGHTNESS, PALPITATIONS
NO HISTORY OF ORTHOPNEA PND
NO HISTOTY OF CONSTIPATION
PAST EXAMINATION:
N/K/C/O DM/HTN/CAD/CVA, ASTHMA, THYROID DISORDERS
H/O SIMILAR COMPLAINTS IN THE PAST RELIVED ON MEDICATION
GENERAL EXAMINATION:
PATIENT CONCIOUS COHERENT COOPERATIVE
TEMP 97.3F
PULSE 96 BPM
RR 20/MIN
BP 140/100mmHg
SPO2 98%
NO ICTERUS PALLOR CYANOSIS LYMPHADENOPATHY CLUBBING
SYSTEMIC EXAMINATION:
CVS:S1S2 HEARD , NO MURMURS.
RS :BAE NORMAL, NVBS
CNS :NO FOCAL NEUROLOGIC DEFICIT
LEVEL OF CONSIOUSNESS: CONCIOUS
CRANIAL NERVES, MOTOR NERVES, SENSORYSYSTEM NORMAL
SPEECH : NORMAL
NO NECK STIFFNESS
NO KERNIGS SIGN
P/A: ON EXAMINATION
SHAPE: OBASE
INSPECTION- ABDOMEN IS PROTRUBURENT
UMBILICUC IS CENTRAL AND INVERTED
NO SCARS, NO SINUSES, NO ENGORGED VEINS
ALL QUADRANTS OF ABDOMEN MOVE EQUALLY WITH RESPIRATION
NO VISIBLE PULSATION
NO VISIBLE PERISTALSIS
PALPATION:
SOFT
NO LOCAL RAISE OF TEMPERATURE
TENDERNESS PRESENT IN EPIGASTRIUM
RIGHT HYPOCHONDRIUM
NO GUARDING, NO RIGIDITY
NO SHIFTING DULLNESS AND NO FLUID THRILL
BOWEL SOUNDS PRESENT
GLASGOW SCALE: 15/15
INVESTIGATIONS
LIVER FUNCTION TEST (LFT) 14-04-2024 04:37:PM
Total Bilurubin 1.3 mg/dl 1-0 mg/dl
Direct Bilurubin 0.47 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 45 IU/L 35-0 IU/L
SGPT(ALT) 49 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
172 IU/L 128-53 IU/L
TOTAL PROTEINS 7.3 gm/dl 8.3-6.4 gm/dl
ALBUMIN 4.5 gm/dl 5.2-3.5 gm/dl
A/G RATIO 1.63
SERUM
AMYLASE 14-04-
2024 04:37:PM
230 IU/L 140-25 IU/L
BLOOD UREA 14-
04-2024 06:51:PM
10 mg/dl 42-12 mg/dl SERUM
CREATININE 14-04-
2024 06:51:PM
1.3 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 14-04-2024 06:51:PM
SODIUM 138 mmol/L 145-136 mmol/L
POTASSIUM 4.7 mmol/L 5.1-3.5 mmol/L
CHLORIDE 102 mmol/L 98-107 mmol/L
COMPLETE URINE EXAMINATION (CUE) 14-04-2024 06:51:PM
COLOUR Pale yellow
APPEARANCE Clear
REACTION Acidic
SP.GRAVITY 1.010
ALBUMIN ++++
SUGAR Nil
BILE SALTS Nil
BILE PIGMENTS Nil
PUS CELLS 4-5
EPITHELIAL CELLS 2-3
RED BLOOD CELLS Nil
CRYSTALS Nil
CASTS Nil
AMORPHOUS
DEPOSITS
Absent
OTHERS Nil
BLOOD UREA 15-
04-2024 12:26:AM
28 mg/dl 42-12 mg/dl SERUM
CREATININE 15-04-
2024 12:26:AM
1.7 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 15-04-2024 12:26:AM
SODIUM 136 mmol/L 145-136 mmol/L
POTASSIUM 5.6 mmol/L 5.1-3.5 mmol/L
CHLORIDE 101 mmol/L 98-107 mmol/L
COMPLETE URINE EXAMINATION (CUE) 15-04-2024 02:35:PM
COLOUR Pale yellow
APPEARANCE Clear
REACTION Acidic
SP.GRAVITY 1.010
ALBUMIN +++
SUGAR Nil
BILE SALTS Nil
BILE PIGMENTS Nil
PUS CELLS 2-3
EPITHELIAL CELLS 2-3
RED BLOOD CELLS Nil
CRYSTALS Nil
CASTS Nil
AMORPHOUS
DEPOSITS
Absent
OTHERS Nil
BLOOD UREA 16-
04-2024 12:00:AM
73 mg/dl 42-12 mg/dl SERUM
CREATININE 16-04-
2024 12:00:AM
2.5 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 16-04-2024 12:00:AM
SODIUM 138 mmol/L 145-136 mmol/L
POTASSIUM 4.9 mmol/L 5.1-3.5 mmol/L
CHLORIDE 103 mmol/L 98-107 mmol/L
URINARY URIC ACID
(24 HOURS) 16-04-
2024 06:23:PM
259 MG/DAY MG/DAY
BLOOD UREA 16-
04-2024 06:25:PM
84 mg/dl 42-12 mg/dl SERUM
CREATININE 16-04-
2024 06:25:PM
2.3 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 16-04-2024 06:25:PM
SODIUM 145 mmol/L 145-136 mmol/L
POTASSIUM 4.5 mmol/L 5.1-3.5 mmol/L
CHLORIDE 106 mmol/L 98-107 mmol/L
LIVER FUNCTION TEST (LFT) 16-04-2024 06:25:PM
Total Bilurubin 2.07 mg/dl 1-0 mg/dl
Direct Bilurubin 0.80 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 38 IU/L 35-0 IU/L
SGPT(ALT) 22 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
123 IU/L 128-53 IU/L
TOTAL PROTEINS 5.9 gm/dl 8.3-6.4 gm/dl
ALBUMIN 3.3 gm/dl 5.2-3.5 gm/dl
A/G RATIO 1.31
SERUM
AMYLASE 17-04-
2024 04:51:AM
76 IU/L 140-25 IU/L COMPLETE URINE EXAMINATION (CUE) 17-04-2024 04:51:AM
COLOUR Pale yellow
APPEARANCE Clear
REACTION Acidic
SP.GRAVITY 1.010
ALBUMIN +++
SUGAR Nil
BILE SALTS Nil
BILE PIGMENTS Nil
PUS CELLS 2-4
EPITHELIAL CELLS 4-5
RED BLOOD CELLS Nil
CRYSTALS Nil
CASTS Nil
AMORPHOUS
DEPOSITS
Absent
OTHERS Nil
LIVER FUNCTION TEST (LFT) 18-04-2024 05:00:AM
Total Bilurubin 3.03 mg/dl 1-0 mg/dl
Direct Bilurubin 1.71 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 60 IU/L 35-0 IU/L
SGPT(ALT) 31 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
180 IU/L 128-53 IU/L
TOTAL PROTEINS 5.9 gm/dl 8.3-6.4 gm/dl
ALBUMIN 3.21 gm/dl 5.2-3.5 gm/dl
A/G RATIO 1.19
BLOOD UREA 18-
04-2024 05:00:AM
91 mg/dl 42-12 mg/dl
SERUM
CREATININE 18-04-
2024 05:00:AM
2.5 mg/dl 1.3-0.9 mg/dl SERUM ELECTROLYTES (Na, K, C l) 18-04-2024 05:00:AM
SODIUM 148 mmol/L 145-136 mmol/L
POTASSIUM 4.4 mmol/L 5.1-3.5 mmol/L
CHLORIDE 106 mmol/L 98-107 mmol/L
COMPLETE URINE EXAMINATION (CUE) 18-04-2024 05:00:AM
COLOUR Pale yellow
APPEARANCE Clear
REACTION Acidic
SP.GRAVITY 1.010
ALBUMIN +
SUGAR Nil
BILE SALTS Nil
BILE PIGMENTS Nil
PUS CELLS 3-4
EPITHELIAL CELLS 2-3
RED BLOOD CELLS Nil
CRYSTALS Nil
CASTS Nil
AMORPHOUS
DEPOSITS
Absent
OTHERS Nil
ABG 18-04-2024 05:19:AM
PH 7.35
PCO2 35.7
PO2 45.1
HCO3 19.6
St.HCO3 20.2
BEB -4.7
BEecf -4.9
TCO2 39.9
O2 Sat 80.1
O2 Count 14.3
BLOOD UREA 18-
04-2024 11:12:PM
101 mg/dl 42-12 mg/dl SERUM
CREATININE 18-04-
2024 11:12:PM
2.8 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 18-04-2024 11:12:PM
SODIUM 153 mmol/L 145-136 mmol/L
POTASSIUM 4.4 mmol/L 5.1-3.5 mmol/L
CHLORIDE 106 mmol/L 98-107 mmol/L
LIVER FUNCTION TEST (LFT) 18-04-2024 11:12:PM
Total Bilurubin 3.18 mg/dl 1-0 mg/dl
Direct Bilurubin 1.96 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 39 IU/L 35-0 IU/L
SGPT(ALT) 25 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
200 IU/L 128-53 IU/L
TOTAL PROTEINS 5.8 gm/dl 8.3-6.4 gm/dl
ALBUMIN 3.1 gm/dl 5.2-3.5 gm/dl
A/G RATIO 1.14
BLOOD UREA 19-
04-2024 11:09:PM
101 mg/dl 42-12 mg/dl SERUM
CREATININE 19-04-
2024 11:09:PM
3.1 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 19-04-2024 11:09:PM
SODIUM 149 mmol/L 145-136 mmol/L
POTASSIUM 4.2 mmol/L 5.1-3.5 mmol/L
CHLORIDE 106 mmol/L 98-107 mmol/L
LIVER FUNCTION TEST (LFT) 19-04-2024 11:09:PM
Total Bilurubin 2.93 mg/dl 1-0 mg/dl
Direct Bilurubin 1.91 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 23 IU/L 35-0 IU/L
SGPT(ALT) 20 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
156 IU/L 128-53 IU/L
TOTAL PROTEINS 5.8 gm/dl 8.3-6.4 gm/dl
ALBUMIN 2.9 gm/dl 5.2-3.5 gm/dl
A/G RATIO 1.0
BLOOD UREA 21-
04-2024 05:06:AM
98 mg/dl 42-12 mg/dl SERUM
CREATININE 21-04-
2024 05:06:AM
2.7 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 21-04-2024 05:06:AM
SODIUM 150 mmol/L 145-136 mmol/L
POTASSIUM 4.2 mmol/L 5.1-3.5 mmol/L
CHLORIDE 104 mmol/L 98-107 mmol/L
STOOL FOR
OCCULT
BLOOD 21-04-2024
05:25:AM
Positive
BLOOD UREA 21-
04-2024 11:36:PM
90 mg/dl 42-12 mg/dl SERUM
CREATININE 21-04-
2024 11:36:PM
3.0 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 21-04-2024 11:36:PM
SODIUM 140 mmol/L 145-136 mmol/L
POTASSIUM 4.1 mmol/L 5.1-3.5 mmol/L
CHLORIDE 106 mmol/L 98-107 mmol/L
LIVER FUNCTION TEST (LFT) 21-04-2024 11:36:PM
Total Bilurubin 3.13 mg/dl 1-0 mg/dl
Direct Bilurubin 1.40 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 26 IU/L 35-0 IU/L
SGPT(ALT) 15 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
137 IU/L 128-53 IU/L
TOTAL PROTEINS 5.6 gm/dl 8.3-6.4 gm/dl
ALBUMIN 2.8 gm/dl 5.2-3.5 gm/dl
A/G RATIO 0.99
SERUM ELECTROLYTES (Na, K, C l) 22-04-2024 04:28:PM
SODIUM 138 mmol/L 145-136 mmol/L
POTASSIUM 3.8 mmol/L 5.1-3.5 mmol/L
CHLORIDE 103 mmol/L 98-107 mmol/L
BLOOD UREA 22-
04-2024 10:43:PM
81 mg/dl 42-12 mg/dl
SERUM
CREATININE 22-04-
2024 10:43:PM
2.7 mg/dl 1.3-0.9 mg/dl SERUM ELECTROLYTES (Na, K, C l) 22-04-2024 10:43:PM
SODIUM 137 mmol/L 145-136 mmol/L
POTASSIUM 3.7 mmol/L 5.1-3.5 mmol/L
CHLORIDE 104 mmol/L 98-107 mmol/L
BLOOD UREA 23-
04-2024 11:28:PM
72 mg/dl 42-12 mg/dl SERUM
CREATININE 23-04-
2024 11:28:PM
2.6 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 23-04-2024 11:28:PM
SODIUM 135 mmol/L 145-136 mmol/L
POTASSIUM 3.7 mmol/L 5.1-3.5 mmol/L
CHLORIDE 102 mmol/L 98-107 mmol/L
BLOOD UREA 24-
04-2024 09:29:PM
61 mg/dl 42-12 mg/dl
SERUM
CREATININE 24-04-
2024 09:29:PM
2.6 mg/dl 1.3-0.9 mg/dl SERUM ELECTROLYTES (Na, K, C l) 24-04-2024 09:29:PM
SODIUM 136 mmol/L 145-136 mmol/L
POTASSIUM 3.6 mmol/L 5.1-3.5 mmol/L
CHLORIDE 101 mmol/L 98-107 mmol/L
LIVER FUNCTION TEST (LFT) 24-04-2024 09:29:PM
Total Bilurubin 1.08 mg/dl 1-0 mg/dl
Direct Bilurubin 0.22 mg/dl 0.2-0.0 mg/dl
SGOT(AST) 34 IU/L 35-0 IU/L
SGPT(ALT) 22 IU/L 45-0 IU/L
ALKALINE
PHOSPHATASE
271 IU/L 128-53 IU/L
TOTAL PROTEINS 6.4 gm/dl 8.3-6.4 gm/dl
ALBUMIN 2.76 gm/dl 5.2-3.5 gm/dl
A/G RATIO 0.76
BLOOD UREA 25-
04-2024 09:24:PM
54 mg/dl 42-12 mg/dl
SERUM
CREATININE 25-04-
2024 09:24:PM
2.8 mg/dl 1.3-0.9 mg/dl SERUM ELECTROLYTES (Na, K, C l) 25-04-2024 09:24:PM
SODIUM 138 mmol/L 145-136 mmol/L
POTASSIUM 4.0 mmol/L 5.1-3.5 mmol/L
CHLORIDE 101 mmol/L 98-107 mmol/L
BLOOD UREA 26-
04-2024 06:10:PM
46 mg/dl 42-12 mg/dl SERUM
CREATININE 26-04-
2024 06:10:PM
2.2 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 26-04-2024 06:10:PM
SODIUM 135 mmol/L 145-136 mmol/L
POTASSIUM 3.9 mmol/L 5.1-3.5 mmol/L
CHLORIDE 101 mmol/L 98-107 mmol/L
SERUM
AMYLASE 27-04-
2024 09:57:AM
41.4 IU/L 140-25 IU/L
BLOOD UREA 29-
04-2024 09:35:AM
44 mg/dl 42-12 mg/dl SERUM
CREATININE 29-04-
2024 09:35:AM
2.0 mg/dl 1.3-0.9 mg/dl
SERUM ELECTROLYTES (Na, K, C l) 29-04-2024 09:35:AM
SODIUM 136 mmol/L 145-136 mmol/L
POTASSIUM 4.1 mmol/L 5.1-3.5 mmol/L
CHLORIDE 103 mmol/L 98-107 mmol/L
TREATMENT GIVEN
LIQUIDS ORALLY AND SOFT DIET
IV FLUIDS NS, RL, DND @ 10O ML/ HR
INJ CLINDAMICIN 600 MG IV/BD
I9NJ MEROPENM 1 GM IV/BD
INJ ULINASTATIN 1 LAKH IU IV/TID
INJ LEVO SULPIRIDE 125 MG IV/BD
INJ THIAMINE 200 MG IN 100 ML NS IV/BD
INJ OPTINUERON 1 AMP IN 100 ML NS IV/OD
INJ PAN 40 MG IV/BD
INJ ZOFER 4 MG IV/SOS
INJ TREMADOL 1 AMP IN 100 NS IV/SOS
INJ LORAZEPAM 1/2 AMP IN 100 ML NS IV/SOS
TAB DOXYCYCLINE 100 MG PO/BD
TAB ARTESUNATE 200 MG AT 2PM
TAB UDILIV 300 MG PO/TID
TAB RIFAGUT 500 MG PO/BD
INJ HUMAN ACT RAPID INSULIN S/C TID ACCORDING TO GRBS
GRBS 7 POINTS PROFILE
TAB RIFAGUT 500 MG PO/BD
ADVICE AT DISCHARGE
FOLLOW SOFT DIET
STRICT ABSTINENCE FROM ALCOHOL
TAB DOXYCYCLINE 100 MG BD FO 10 DAYS'
TAB THIAMINE 100 MG BD
PAN 40 MG PO/OD
TAB CREON 25000 IU PO/TID
REVIEW TO MEDICINE OPD WITH FBS/ PLBS/ HBA1C AFTER 1 WEEK
COURSE IN THE HOSPITAL:
45 YEAR OLD MALE SOIL MINNING WORKER BY OCCUPATION CAME TO CASUALTY WITH
ABOVE MENTIONED COMPLAINTS WITH VITALS BP: 140/100 PULSE:96 RR;18 TEMP; 97
GRBS: 142 ON FURTHER EVALUATION SERUM AMYLASE: 230, SERUM LIPASE: 112, SERUM
CREATITINE:1.3 TLC: 25,200 AND DIAGNOSED WITH ACUTE PANCREATITIS WITH ?SUB
ACUTE PERITONITIS AND SHIFTED TO AMC AND RYLES WAS PLACED, MAINTAINED ON NBM
STARTED ON IV FLUIDS ANTIBIOTICS AN D ADEQUATE PAIN MANAGEMENT
DAY 1: PATIENT COMPLAINED OF PAIN IN EPIGASTRIC REGION AND FEVER SPIKES WERE
PRESENT, TENDERNESS PRESENT IN EPIGASTRIC AND HYPOCHONDRIUM
SIRS CRITERIA 4 POINTS
RANSONS SCORE: 1 POINT ON ADMISSION
BISAP SCORE: 3 POINTS
CREATININE CLEARANCE 34 ML/MIN
BUN: 34.1
SERUM POTASSIUM: 5.6 SALBUTAMOL NEBULISATION WAS GIVEN
AND CONTINUED ON FLUID THERAPY AND SURGERY REFERRAL WAS DONE AND ADVISED
X RAY ERECT ABDOMEN AND REVIEW USG, ESR , CRP, SERUM LACTATE INVESTIGATIONS.
PSYCHIATRY REFERRAL WAS DONE DIAGNOSED WITH ALCOHOL DEPENDANCE
SYNDROME
AND TOBACCO SYNDROME AND ADVISED INJ LORAZEPAM 1/2 AMPULE IM AND SOS IF
PATIENT IS IRRTABLE OR SLEEPLESS
DAY 2: PAIN ABDOMEN SUBSIDED, FEVER SPIKES WERE PRESENT AND PASSED STOOLS
REVIEW USG SHOWED ACUTE PANCREATITIS WITH BILATERAL PLUERAL EFFUSION,
MODERATE ASCITIS AND GRADE I FATTY LIVER
GASTRO REFERRAL WAS DONE ADVISED INJ ULINASTATIN AND INJ LEVOSULPIRIDE
RANSONS SCORE: 4 POINTS WITHIN 48 HRS
CREATININE: 2.5AND HYPERKALAMIA RESOLVED
DAY 3: PAIN ABDOMEN SUBSIDED, FEVER SPIKES WERE PRESENT, SLUGGISH BOWEL
WERE PRESENT, TENDERNESS PRESENT INN EPIGASTRIC REGION, SPO2: 87% ON ROOM
AIR, 97% ON 2 LITRES OXYGEN AND STARTED ON INJ CLINDAMICIN. REVIEW SURGERY
OPINION WAS DONE ,ADVISED TO CONTINUE SAME TREATMENT AND NO ACTIVE
SURGICAL INTERVENTION NEEDED.
DAY 4: NO COMPLAINTS OF PAIN ABDOMEN, FEVER SPIKES WERE PRESENT, NO
ABDOMINAL TENDERNESS , BOWEL SOUNDS WERE SLUGGISH, ON AUSCULATION CREPS
PRESENT IN RIGHT MA,IAA , AND CONTINUED ON SAME TREATMENT.
DAY 5: FEVER SPIKES WERE PRESENT AND PAIN ABDOMEN SUBSIDED, NO ABDOMINAL
TENDERNESS, SPO2: 92% ON ROOM AIR, SERUM SODIUM: 153 AND FLUID THERAPY WAS
MAINTAINED WITH 0.45 NS AND GRBS 7 POINT PROFILE MONITORING WAS STARTED IN
VIEW OF UNCONTROLLED SUGARS AND STARTED ON INJ. HUMAN ACT RAPID INSULIN
ACCORDING TO GRBS.
DAY 6: FEVER SPIKES WERE PRESENT, SUGARS WERE WELL CONTROLLED, STOOL FOR
OCCULT BLOOD WAS POSITIVE AND ORAL LIQUIDS WERE ALLOWED
PULMONOLOGY REFERRAL WAS DONE IN VIEW OF BILATERAL PLUERAL EFFUSION AND
ADVISED USG CHEST TO QUANTIFY EFFUSION AND TAPPING FOR PLUERAL FLUID
ANALYSIS AND REVIEW USG CHEST SHOWED MILD PLUERAL EFFUSION (NON TAPABLE)
DAY 7: PAIN ABDOMEN PRESENT, FEVER SPIKES PRESENT, AND STARTED ON INJ
MEROPENEM AND TAB RIFAGUT
DAY 8: FEVER SPIKES WERE PRESENT, PAIN ABDOMEN SUBSIDED, LFTS WERE DERANGED
AND STARTED ON TAB UDILIV, TAB DOXYCYCLINE AND TAB ARTISUNATE AND PERIPHERAL
SMEAR FOR MALARIAL PARASITE WAS NEGATIVE
DAY 10: FEVER SPIKES WERE PRESENT, PAIN ABDOMEN WAS PRESENT AFTER FOOD
INTAKE
DAY 11: NO FEVER SPIKES WERE PRESENT AND PAIN ABDOMEN WAS PRESENT AFTER
FOOD INTAKE AND TLC WAS DECREASED FROM 30,000 TO 22,000 . LFTS WERE NORMAL
DAY 12: PT WAS TAKEN TO GASTRO REFERRAL AND ADVICED REVIEW USG . USG SHOWED
PERIPANCREATIC FLUID COLLECTION AND ADVISED CT , CT SHOWED ACUTE
PANCREATITIS AND SURGERY REFERRAL WAS DONE IN VIEW OF PERI PANCREATIC FLUID
AND THEY ADVISED USG
LAST DAY: PATIENT WAS HEMODYNAMICALLY STABLE WHILE GETTING DISCHARGED
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