43/M with PANCREATIC PSEUDOCYST

 Unit 3 

Interns:

Dr Archana

Dr Sreeja

Dr Harsha 

Dr Kalyan 

Dr Sahithi 

Dr Jeehariki

Dr Raveen PGY1

Dr Aashitha PGY2

Dr Aravind PGY3

Dr Vamshi PGY3

Dr Hareen SR

Dr Praveen Naik Ass Prof

DR. RAKESH BISWAS HOD

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Here is a case i have seen:

Admission under unit 3 on 03/02/2021

43 year old man working as an electrician presented to casualty with the complaints of

Pain abdomen since 1 week

Patient has been an alcoholic since 15 years with a daily whiskey consumption of 90-180ml. He also has been a Smoker since 15 years with around 1 pack of cigarettes per day. 

Since 1 year he has been experiencing on and off abdominal pain which would relieve on medications.

2 months back he got admitted for pain abdomen in the epigastrium, which was radiating to his left shoulder. His pain abdomen would relieve on bending forward.

He was diagnosed with acute pancreatitis back then.

Now he has presented to us with the complaints of pain abdomen in epigastrium, not associated with vomitings or nausea since 1 week. Not relieved on bending forwards. Aggravated on food intake.

He also complains of left lower back pain radiating to left iliac region since 1 week.

Not a K/C/O DM-2,Hypertension,asthma,TB,CVD

General examination:

Patient is conscious,coherent, cooperative

PR-84bpm

RR-18cpm

BP-130/70mmHg

Temp-98.8F

Cvs - S1, S2+

Lungs - clear on auscultation, BAE+

Per Abdomen -

Tenderness in epigastrium, and left iliac fossa

Investigations : 

CT SCAN done 2months back

Upper GI ENDOSCOPY - done 2months back

Investigations done here : 

Diagnosis :? PANCREATIC PSEUDOCYST

           ? WALLED OFF NECROSIS

Treatment : 

1.Encourage oral feeds

2. IV Fluids

3. Inj Pantop 40mg/IV/OD

4. Inj Tramadol 1 amp in 100ml NS/IV/BD