CaseDiscussion_ABD pain

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1 Nov 2016 - General

A middle aged gentleman with background history of alcohol liver cirrhosis (with oesophageal varices, and ascites), hypertension, smoker of 30 pack years, on-going intermittent alcohol comsumption, was admiited to hospital due to increased in abdominal distension and generalised abdominal pain. He was not drinking any alcohol for the last 2 weeks, but did drank heavily for 1 week prior to that. Patient was no encephalopathy on admission. On examination, patient's abdomen was grossly distended with positive shiftinh dullness, some generalised slight tenderness on palpation. Patient's vitals (blood pressure, respiratory rate, oxygen saturation, temperature, pulse rate) were normal. PFA was normal. There were slight increased in white cell count, neutrophil and CRP, with stable liver function test. What is your differential diagnosis for his abdominal pain ? what is the next appropriate diagnostic test and management plan ?? 

According to the clinical guidelines relating to this case, a paracentesis should be performed in all patients with cirrhosis and ascites to rule out SBP. The same procedure should also be performed in patients with gastrointestinal bleeding, shock,...
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The patient has a history of alcohol liver cirrhosis, complicated with oesophageal varices and ascites (due to portal hypertension). Given the presentation of abdominal distension and pain, X-ray of abdomen (PFA) will be first required to rule out an...
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The patient is chronic alcoholic he used to drink but consumed before consultation. I am guessing it as IBD so, after alcohol consumption it triggered again but previous pain status not disclosed here. It also evident that blood test is also voting ...
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