A 35 YEAR OLD MALE WITH LIVER ABSCESS

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LIVER ABSCESS


35 year old male came to our hospital with chief complaints of upper abdomen pain since one week, fever since one week.

Patient was apparently asymptomatic 1 week ago, then developed pain abdomen which was insidious in onset, gradually progressive. Pain in right hypochondrium and gastric region with no aggravating and relieving factors.

Fever is on and off since one week, high grade not associated with chills and rigor, cold, cough, body pains, nausea vomitings, loose stools and constipation.

No history of bleeding manifestations.


PAST HISTORY

Not a k/c/o T2DM,HTN,asthma , epilepsy,TB 


PERSONAL HISTORY

Diet - mixed

Appetite - decreased since 1 week

Sleep- adequate

Bowel movements- normal

Addictions- alcohol, regular, since 10 years

Smoking, 10 pack years


General physical examination

Pt is conscious, coherent, cooperative, 

Icterus- present 

 Vitals-

Temp- afebrile 

Bp-110/70 mm hg

Pr- 86 bpm

Rr-20 cpm

Spo2- 98% on RA


Systemic examination

RS- bae+, nvbs

Cvs-S1 S2 +

P/A - tenderness + at right hypochondrium and epigastric region

Sluggish bowel sounds heard

Cns- nad







                  X ray erect abdomen




USG


FEVER CHART



ECG


Investigations

3/2/22

HB-10.2

TLC- 17,900

PLT- 5.1


Serum amylase- 60 

Serum lipase- 28


RFT

Serum urea- 37

Serum creatinine- 1.1

Sodium- 130

Potassium- 6

Chloride- 98


3/2/22

LFT

TB- 4.40

DB- 3.12

AST/ALT- 96/145

ALP- 586

TP- 5.3

Alb- 2.6

A/G- 0.94


PT -17 sec

APTT- 34 sec

INR- 1.25 









                     Surgery referral




Diagnosis
Liver abscess secondary to ? Amoebic or pyogenic 

Plan of treatment 
1. INJ. METROGYL 750MG/IV/TID
2. INJ. MAGNEX FORTE 1.5MG/IV/BD
3. INJ. PAN 40MG/IV/BD
4. INJ. THIAMINE1 AMP IN 100ML NS/IV/ OD OVER 30 MIN
5. INJ. TRAMADOL 1 AMP IN 100ML NS/IV/OVER 30MIN/ SOS
6. INJ. DICLOFENAC 3ML=75MG IM/BD
7. TAB. PCM 650 MG PO/QID
8. INJ. NEOMOL 1G IV/SOS








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