Abdominal distension

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Chief complaints:

HOPI:

4 Months back patient developed fever which is continuous , Low grade and Fever is associated with vomiting which is bilious type,foul smelling,food as content ,non blood stained ,2 to 3 episodes per day went to local hospital and found he is suffering Liver disease.They treated him and symptoms susbsided.

 2 months back he developed bilateral lower limb swelling ,pitting type ,swelling present upto thighs and also developed Abdominal distension.History of shortness of breath , Garde 4 ,No chest pain,No orthopnea,No PND.For which they went to local hospital and swelling and distension decreased.

He developed same complaints since 10 days.

PAST HISTORY:

K/CIO T2DM Since 6 Months and is on unknown medication.

N/K/C/O Hypertension,Epilesy, Asthma, Thyroid disorders.

PERSONAL HISTORY:

DIET :mixed

APPETITE :disturbed

SLEEP: disturbed

H/O Alcohol intake Since 20 Yrs every day about 50 to 100 ml

No H/O Tobacco intake

No H/O Allergies

FAMILY HISTORY: 

N/K/C/O DM, Hypertension,Epilepsy, Asthma, Thyroid disorders.

GENERAL EXAMINATION:

Patient is conscious,coherent and co operative.

Well oriented to time,place and person

Pallor: +

Edema present upto thighs

No Icterus,clubbing,cynosis,lymphadenopathy 

VITALS:

TEMP: 98.2F

BP: 120/80 MM/HG

PR: 84 BPM

SPO2: 99%

RR: 16CPM

SYSTEMIC EXAMINATION:

PER ABDOMEN:

INSPECTION:

Abdomen - Distended

Umbilicus-central and everted

Scars present 

Distended veins present.

No sinuses,No visible peristalsis.

Investigations: