Download - Interesting Case16-8-15 Sx gen4.pptx
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Interesting Case17.08.2015
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Patient Identifcation HN IZ6233 ! "# 6$ %
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C?ie@ CoABaint
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PRESENT ILLNESS
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Present iness .1"/PJ'%"7(.5'1"/'%"9()!5(1"8"!%K
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^ee_ant Histor` 2 .1"/ PJ );![!%KG(;:*
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PAST HISTORY
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Past Histor`
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Persona Histor` '&::#5(%K
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aAi` Histor` b,.&&L/8(":8(4
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Systemic review
hJ '%&>,% ;8#(.(1K" HjjN ']%(=9 ''%.&'59 >'".5M/ 5,/.!
74/!4F&"D
Heart ''%L&4K/ /"/(: ''%5":.5/1K">"/7*81/ k\ng 5L7>, ''%".(1F"(4'5": JldoAen !""15*4(4:(9!/"5(.M/ "#(9&%V%''%!"7&*4:!".&%
m ''%4&&9)&:D4 ''%4&&9D#/ N (&E7>4% '&4:&/ ' '47 '""/)( Q\sc\osWeeta ''%7*'./1F"*%: 'D"
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Pro_isiona iagnosis C?oangiocarcinoAa
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iperentia iagnosis qq
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iperentia iagnosis S HeBatoce\ar carcinoAa 2 hastone
3 C?ronic HeBatitis U $
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P?`sica jaAination
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P?`sica eaAination henera aBBearance Jn eder`
Aan ooWs sicWgood conscio\snesse cooBerati_e0
uita sign 360v wC P^ 62 lBA ^^ 2T tBA P S22 AAHg
HjjN BinW conx\ncti_ae ictericscerae cer_ica `AB? node ands\Braca_ic\ar `AB? node ereiABaBale
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Heart norAa S2 no A\rA\r k\ng norAa lreat? so\nd ey\a lot?
\ngs no ad_entitio\s so\nd JldoAenso@t no tenderness No
s\Berfcia _ein diatation No _isileBeristasis No aldoAina distention norAoacti_e loe so\nd z\id t?rinegati_e s?i@ting d\ness negati_e BaBale i_er S leo rig?t costa Aargin
P on Bosition deeB `eois? liecoor no oo{ing o\nd UTTR$TT cc jtreAities No Bitting edeAa No ras?
No Betec?iae
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JldoAen
deepyellowish
bile color
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kal In_estigationCCJkCoag\ograA
jectro`te|Rra`jmhCjJ
^ena \nctionC|^C scan}
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CC Hl ~ S20S gd Hct ~ 3U0S Y Pateet~ 326TTT C ~ 6TTces
QCu ~ v$06 @k PQN~ 6$0v Y k`AB?oc`te ~ 03 Y
Qonoc`te ~ v0v Y josinoB?is ~ U0S Y asoB?is ~ T 03 Y
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ki_er \nction test C?oestero SvT
ota Brotein0$ Jl\Ain 30U hol\in U0S
$06 $0U Jk STU J S2S JkP ST
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ood C?eAistr` Na S3S Ajyk m 303 Ajyk C v2 Ajyk Ca 0$ Ajyk
HC3
2v02 Ajyk Qg 20S P 30T N v0 Cr T0
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rine Jna`sis Coor `eo \rlidit` cear B0gr0 S ^C negati_e BH $ Cnegati_e
ke\Woc`te negati_e Nitrite negati_e h\cose negati_e metone negati_e
iir\lin negati_e ood negati_e CR ^C R
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InvestigationCEA : 7!.10 "0#2.5$CA1%#% : 281.5 "0#!7$A&' : .51 "0#10$()sAg : *eg
Anti#()s : 'osAnti#(C+ : *eg
Anti#(I+ : *on#reactive
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Q^CP X2v$ IABression ki_er Aass at segAent $6
it? sAa nod\es nearl` CHCJ it?nod\es Aetastases0 Berid\cta a Aass
at rig?t ?eBatic d\ct ca\sing liiar`olstr\ction se_ere on t?e rig?t ole i_er0jncased anterior and Bosterior lranc? o@rig?t Borta _ein0
Q\tiBe aldoAina kNs Aetastases0Qid distension o@ h it? stones denselie and c?ronic inzaAAation0
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,reat-ent# 'lan : ight lobe(epatecto-y# 'alliative d/e to iver cirrhosis
# edication :# Aldactone :# eno3ot
# 4o6acine # etronidaole # ) co-ple6
'araceta-ol