Case of Liver Failure

CASE OF LIVER FAILURE with septicemia with encephalopathy advise LIVER TRANSPLANTATION.

52 yrs lady brought by being carried by 4 person in the the state of  semicomatose,  abdomimal distention, high grade fever ,was admitted in ICCU at Hyderabad, Mumbai,Nagpur with no results; Patient went on getting worse and finally  advised LIVER TRANSPLANTATION with No Guarantee of survival with or without transplantation and came here with no hope and for last choice just

A CASE OF CHRONIC LIVER DISEASE WITH DRUG INDUCED LIVER INJURY WITH DECOMPENSATED ASCITES & JAUNDICE GRADE II HEPATIC ENCEPHALOPATHY WITH URINARY TRACT INFECTION WITH PULMONARY PNEUMONITIS.

CLINICAL PRESENTATION:-

A 52 year old lady brought by his relative with complaint of

  • Drowsiness,
  • Slurred speech,
  • Not willing to sit and talk only wants to lie down,
  • Need support while walking since a month,
  • Swelling all over body,
  • Fullness of abdomen,
  • Yellowness all over body since 4 months,
  • No desire to live, Angry, Irritable, Abusive, Violent, Quarrelsome, Kuch to de, ke muze mardo, muze jina nahi hai.

FINAL DIAGNOSIS;-

  • Chronic liver disease
  • Drug induced liver injury
  • Decompensate ascites and jaundice
  • Grade II hepatic Encephalopathy
  • Urinary tract infection
  • Pneumonitis

Before came to us she was suffering from

  • high grade fever
  • Septicemia
  • Encephalopathy
  • with following report

After allopathic Treatment

      (Antibiotics, steroids)

ALTHOUGH SGOT, SGPT IMPROVING BUT BILLIRUBIN INCREASED AND PATIENT’S GC WAS ALSO DETORIATING DAY BY DAY AND DOCTORS ADVISED HER FOR LIVER TRANSPLANTATION AT THE COST OF RS. 25-30 LACS WITH NO GUARANTEE OF RECOVERY.

GENERAL EXAMINATION:-

  • BP:- 90/60
  • PULSE:-100/m, Regular, tachycardia
  • TEMPRATURE:- 99 degree
  • RESPIRATIORY RATE:- 28/m, Tachypnoea,
  • PALLOR:- ++nt
  • TONGUE: – Dry/ coated.
  • ICTERUS:- +++nt
  • LYMPHADENOPATHY:- not +nt
  • OEDEMA:- pitting oedema all over body
  • ABDOMEN:- Ascities +++nt,
  • ABDOMINAL GIRTH:- 103 cm
  • JVP (Jugular venous pressure) :- Elevated
  • Nail:- clubbing- absent
  • Flapping tremors +++nt

SYSTEMIC EXAMINATION:-

  • CNS:- Encephalopathy +++nt, pupils-normal, Semiconscious state,
  • CVS:- Tachycardia +nt, HS- normal,
  • RS :- Tachypnoea +nt, s/o ARDS, ronchi +nt
  • GIT:- Distension of abdomen

LIFE SPACE :-

  • She is ..
  • .
  • .
  • .
  • .
  • she want normal delivery.

 During Illness:-

  • Irritable,
  • Quarrelsome,
  • Contradiction intolerance
  • Conscientious:- because she realize that on her illness spend more money, and when Dr. advised transplantation she said to her family members don’t do this, inspite of that give money to her sisters daughters marriage because of dowry problems going in her marriage.
  • On observation:- looking ugly, dark complexion, reversed frown, voice loud,

AFTER PRESCRIPTION

FOLLOW UP: –

AFTER 6 HRS

  • Drowsiness>>,
  • Toxicity of face>,
  • Hungry,
  • Love of life
  • Muze thik kardo, muze jina hai,
  • Weight:- 78.6 kg
  • Abdominal girth:- 100cm
  • BP:- 100/60

Next day:-

AFTER 12 HRS

  • Feels better than yesterday, looks better,
  • Now she feels that she will going to recover, hopeful for recovery.
  • Sleep better at night, no dreams of dead bodies,
  • She said internally I feel to be live,
  • She walks without support yesterday night.
  • Sit on chair after so many days,
  • Abdomen feels soft,
  • And since morning she is waiting for doctor for talking,
  • Patient was loquacious but still she was unable to talk yesterday due to breathlessness but today she talk comfortably that means breathlessness was gone,

She said, yesterday I feel that you doctors only asking question not give medicines but now she feels sabudane k goline itana asar kiya k bat karneme taklif bhi nahi ho rahi, she loves to talk that much that she was eagerly waiting for doctor for talking.

Reports:-

AFTER TREATMENT:-SCIENTIFIC MIRACLE HAPPENED LIVER RECOVERED AND ALL REPORTS ARE NORMAL