acute pancreatitis with alcohol dependency
acute pancreatitis with alcohol dependency
Patient was apparently asymptomatic one day back after which he started developing pain in abdomen ( colicky type,non radiating,no aggregating or relieving factors
History of present illness
H/o of vomitings (4 episodes)
Bilious non projectile
H/o fever low grade
No h/o loose stools
No h/o outside food consumption
He had similar complaints in 2018 and had hospital admission
Past history
Alcohol consumption and have alcohol dependency :
He started consuming alcohol in the form of whisky because of peer pressure
H/o alcohol consumption (1 beer/ day )
Consumes alcohol from 16 yrs
Had a break of 2 years of drinking whisky and again started drinking in a occasion from past 8months (4-6units/day )
Tobacco consumption (smoking):
4 yrs back (1 packet /2-3days)
Sleep history :
He is having sleep disturbances
Continued drinking despite knowing harmful consequences
Family history :
No family history
Personal history:
Diet:mixed
Appetite: decreased
Bowel and bladder : regular
Addictions: alcohol and smoking
Cage assessment:
A- is positive had anger issues
C- is positive wanted to cut down alcohol
G- positive felt guilty
E- negative (morning drinking)
General examination:
A 45 yr old patient ,supine decubitus who is well nourished is conscious,cooperative,comfortably seated /lying on the bed,well oriented to time ,place and person
There is no pallor ,cyanosis,lympadenopathy, dehydration, icterus, clubbing of fingers,oedema of feet
Vitals:
Temp:98.7°c
Respiratory rate:12 cycles/min
Bp:120/80
Systemic examination:
No hypertrophy in gums and mucosa
Inspection:
Umbilicus shape normal (spherical)
Position - central
No herniation/ discharge
No movements with respiration
Abdomen - fullness and tight abdomen
Skin over abdomen - normal with no pigmentation
Palpation:
Pain above the level of umbilicus
Pain can be perceived every region but most prominent in epigastric region
No engorged veins ,visible pulsations, hernial orifices
Superficial:rigidity present
Deep: no case of ascites and fluid thrush
Spleen : not palpable
Cerebellar signs
Fingernose in coordination - no
Knee heel in coordination - no
Normal gait
Normal breath sounds
No murmurs heard
Diagnosis: pancreatitis caused by secondary cause of alcoholic dependency
Serum creatinine:
Blood urea
Blood urea
Lipase:
Amylase:
