Liver disease secondary to ALCOHOL consumption
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A 36 year old male who is plumber by occupation came to the OPD complaining about
- Yellowish discoloration of his eyes since 1 month
- Reddish discoloration of urine since 1 month
HISTORY OF PRESENT ILLNESS:
Normal routine of the patient:
He used to get up at 6.30/7 in the morning, used to have tea and passed the time until afternoon talking to his friends then used to have lunch at 1 PM which is rice.He used to return home by 6 in the evening then he used to freshen up and drink alcohol (150-200ml per day) and used to have dinner at 9 PM and sleep after that.
The Patient was apparently asymptomatic 1 month back then he observed yellowish discoloration of his eyes along with reddish discoloration of urine.
He then visited a local hospital for which he was given few tablets. Since the patient didn't find a change, he started taking herbal medication.
He used to have intermittent low grade fever that lasted for approximately one/two hours for which he used to take a PCM tablet.
Since the symptoms didn't subside, he came to the OPD with the same complaints
History of past illness :
The patient is not a known case of diabetes, epilepsy, tuberculosis, asthma, hypertension
Personal history :
- The patient has no loss of appetite
- He takes mixed diet
- No sleep disturbances
- He consumes 150-200 ml of alcohol daily, was a cigarette smoker 5 years back where he used to take 2/3 cigarettes per day.
Family history :
- There are no similar complaints in the family members
Treatment history :
- He is not a known case of drug allergy.
General examination :
- Patient is conscious, coherent, cooperative at the time of joining
- No Pallor
- Icterus present
- No cyanosis
- No clubbing of fingers and toes
- No lymphadenopathy
- No pedal edema
The patient complains of black stools since he started taking medications
Vitals : temperature - 98.4 F
Pulse rate - 84 bpm
Respiratory rate - 18 cycles per minute
BP - 110/80 mm Hg
Systemic examination :
CVS
Inspection - chest wall is bilaterally symmetrical
- No precordial bulge
- No visible pulsations, engorged veins, scars, sinuses
Palpation - JVP is normal
Auscultation - S1 and S2 heard
RESPIRATORY SYSTEM
- Position of trachea is central
- Bilateral air entry is normal
- Normal vesicular breath sounds heard
- No added sounds
PER ABDOMEN
- abdomen is not tender
- bowel and bladder sounds heard
- no palpable mass
- patient has mild amount of fluid
CNS
- Patient is conscious
- Speech is present
- Reflexes are normal
Investigations :
13/11/21
Diagnosis : Liver disease secondary to alcohol consumption
Discussion :
What are the organs other than liver affected by ethanol consumption ?
How far genetic manipulation {if any} (that can alter the susceptibility of organs to ethanol) can prevent the toxic effect on organs?
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