Patient was diagnosed Alcoholic cirrhosis on the basis of the history http://care.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=208 uploaded by our TCHE, Mr Kar. On presentation to PCMS, Bhopal, patient had the problem of irrelevant behavior for which he was investigated for hepatic encephalopathy possibly precipitated by spontaneous bacterial peritonitis although investigations toward these were negative.

He had a large umbilical hernia as well as hydrocele (see clinical images in input page linked above) as a result of his long standing ascites and these were successfully operated on with tremendous subjective relief for the patient. As the patient manages a liquor shop and prepares country liquor the chances of his recurrence of alcoholism are very high and a red alert has been sounded to the TCHE and the patient's family to protect him from all triggers toward alcoholism and if possible change his job. He was offered the job of a lift-operator in PCMS, Bhopal but preferred to return to his village.