Low Backache with cirrhosis and past Infective Endocarditis and valve replacement
18-4-13
History of 42y male resident of Guna taken by intern Dr Nisha Rohit posted in Medicine Unit II PCMS Bhopal
Came to PCMS,Bhopal with the complaint of -
1.Low Backache since 3 months
2.Right hypochondrial discomfort since 3 months
HOPI - As per the patient he was apparently alright 3 mnth back then he develop low backache gradual in onset occur while on sitting from lying down position persist for 15min get relief on itself,on rest and on medication.radiate over both gluteal region.
PAST HISTORY
He had the complain of fever 6y back continuos type,low grade not associated with chill and rigor.He consult at Indore Govt. Medical College Where he diagnosed as Infective Endocarditis (Vegetation over the aortic and mitral valve) With severe MR and AR on ECHO.He took Penicillin and Amoxillin for 1mnth but didn't get relief.Then he advised for Valve replacement.He operated at BMHRC,Bhopal on March 2006 Double valve replacement.Now he is on T.Carvedilol and warfarin.
PERSONAL HISTORY
Appetite-Adequate
Sleep -Adequate
Bladder and Bowel Habit - Normal
Non Alcoholic
FAMILY HISTORY
No family member suffered from the same complain
PER ABDOMEN EXAMINATION
1.Soft and nontender
2.Liver not palpable
3.Spleen is enlarge by 5cm below the subcostal margin,nontender
SURFACE -smooth ,MARGIN - regular
ON INVESTIGATION
1.X-RAY of LUMBAR REGION - Straightening of lumbar spine
2.X-RAY of PELVIS - Blurring of Right Sacroiliac joint
3.USG of ABDOMEN - Splenomegaly with coarse reflectivity of Liver and Contracted Right lobe of liver.
4.LFT - S.protien,S.Bilurubin,SGOT,SGPT within NORMAL range.
5.USG - Presence of Oesophgeal varices
ArogyaUDHC