Ascites is the pathologic accumulation of fluid within the peritoneal cavity. It is the most common complication of cirrhosis and occurs in about 50% of patient with decompensated cirrhosis in 10 years. The development of ascites denotes the transition from compensated to decompensated cirrhosis. The main symptoms of ascites are a large belly and rapid weight gain. Other symptoms include: Swelling in your ankles. Shortness of breath. Digestive issues, such as bloating, abdominal pain, loss of appetite, indigestion and constipation. Back pain. Difficulty sitting. Fatigue.

2. PATIENT DETAILS:
Patient Name: Kiran Age: 60yrs Sex: male
IP No: 2511 DOA: 2/11/22 DOD:10/11/22
Department: GMW
CHIEF COMPLAINTS:
• Abdominal distention
• No urine output for 2 days

3. ON EXAMINATION
Temp: 98.6
Pulse Rate: 85 b/m
SPO2 : 96%
BP : 120/90 mmHg
Social History :
Diet : Non veg
Alcohol : Yes , since from 10yrs

4. PAST MEDICAL HISTORY
 Hypothyroidism
 Diabetes
 Hypertension

5. PAST MEDICATION HISTORY
Levothyroxine : 25mcg
Irregular drug use for diabetes
Amlodipine : 5mg

6. LABORATORY INVESTIGATIONS
Parameters Observed
Values
Normal Values Units
Hemoglobin 9 14- 16 g/dl
ESR 80 1- 7 mm/hr
Platelet Count 2,00,000 1,50,000-
4,00,000
Cells/cumm
RBC 2.8 3.8-5.8 Millions/cumm
Neutrophils 80 40-75 %
Lymphocytes 10 20- 45 %
Serum
Creatinine
1.8 0.6-1.2 mg/dl

7. LABORATIRY INVESTIGATIONS
Parameters Observed
Value
Normal Value Units
Na+ 133 134-155 mEq/l
Chlorides 81 98-107 mEq/l
Fasting Blood
Sugar
130 70-110 mg/dl
Random Blood
Sugar
266 110-180 mg/dl
TSH 0.38 0.35-4.0 mlu/ml
FT4 1.0 0.8-1.8 ng/dl
FT3 3.5 2.3-4.2 pg/dl

8. US- ABDOMIN ;

9. IMPRESSION ;
Moderate free fluid seen in the abdomin.
Bilateral moderate pleural effusion.
DIAGNOSIS :
ASCITES

10. DEFINITION :
Ascites is defined as the accumulation of free fluid in the
peritonial
Cavity.
ETIOLOGY :
It can be caused due to the liver problems like
cirrhosis, acute liver failure, others like heart failure,
nephrotic syndrome, disorders of pancreas.

11. PATHOPHYSIOLOGY :

12. PRESENT MEDICATION HISTORY :
s.no Brand
Name
Generic
Name
R.O.A Dose Frequenc
y
1. Uribid Nitrofurant
oin
po 100mg OD
2. Thyronor
m
Levothyro
xine
po 25mcg OD
3. Ursocol Ursodeox
ycholic
po 300mg OD
4. Glyset Miglitol po 25mg BD
5. Norvasc Amlodipin
e
po 5mg 0D
6. Pantop Pantapraz
ole
po 40mg 0D
7. Benfoplus Folicacid ….. …….. BD
8. Aldactone spironolac
tone
po 100mg BD

13. SOAP NOTES :
Subjective –
Abdominal distension, no urine output for 2days.
Objective –
Hb ; 9gm
ESR ; 80mm/hr
RBC; 2.8
Neutrophils; 80
Lymphocytes; 10 Na+; 133
Serum creatinine; 1.8 Cl-; 81
FBS; 130
RBS; 266

14. ASSESMENT
ASCITES
PATIENT COUNSELLING :
Limit alcohol intake.
Weight loss
Exercising
Limit salt intake
Once it is arrived, to check that not to be prone.

15. PRESENTED BY:
M. DURGA ROHITHA
PHARM-D IV YEAR
174T1T0005