Chandana vishwanatham

 Admission -13/1/22 60/F came to casualty with c/of pain abdomen since 1 month  Yellowish discoloration of eyes since 15 days  Vomitings since 15 days sob since 15 days  Decreased appetite since 15 days Patient was apparently asymptomatic 1 month back  Had H/of pain abdomen on and off since 1 month - insidious onset, intermittent , diffuse and burning type of pain associated with decreased appetite taking only fluids since 15 days f/by vomitings - bilious, non- projectile, food or water as content whenever patient is taking oral feeds Yellowish discoloration of eyes since 15 days  Sob since 15 days inscidious onset gradually progressed from grade 2 to 3 associated with pedal odema and decrease urine output  not associated with fever, cold, cough, orthopnea and PND No pale coloured stools, mucous , blood or dark coloured stools  0/examination: pt-conscious and tachypnic  Afebrile  Icterus +  No pallor, cyanosis, clubbing, lymphadenopathy PR - 90 bpm  BP- 130/80 mm of hg  RR - 34 cpm