48 year male with abdominal distension
 
48 year old male resident of Chityala Auto Driver by occupation  CHIEF COMPLAINTS  Abdominal distension since 20 days   Breathlessness since 20 days  Swelling of bilateral lower limbs since 20 days  Decreased urine output since 3 days  HISTORY OF PRESENTING ILLNESS  Patient was apparently asymptomatic 20 days back then he developed abdominal distension which was insidious in onset ,gradually progressed to present size . It is diffuse type of abdominal distension H/o  Shortness of breath since 10 days initially he used to walk to his home without any problem  after parking his auto at a distance from home.Now he has to take rest after walking such distance (MMRC grade 2) .Distension doesn’t change with position  No h/o  orthopnea ,PND,abdominal pain ,vomitting ,obstipation . Swelling of bilateral lower limbs since 15 days insidious in onset , gradually progressive upto knee level, pitting type (grade 2) reduced  on  walking ,no change at rest ...
 
 
 
