30 year old female with ascitis

 30 YEAR OLD FEMALE WITH ABDOMINAL DISTENSION AND BILATERAL PEDAL EDEMA. 


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A 30 year old woman presented to opd with the complaints of Abdominal distension since 4 months,
Dyspnea at rest since 4 months 

She used to work as a coolie and was married at the age of 18 years. She has given birth to 4 children, 3 daughters and one son(the youngest), all through normal vaginal delivery. Her last delivery was 20 days back and the abdominal distension which she developed during pregnancy was gradually progressive and often felt dyspneic especially on exertion. She even had bilateral lower limbs swelling extending to her knees which resolved on its own. 
On further questioning, she gave a history of non productive cough which lasted for a month prior to her son's delivery 
Obstetric history- P4L4
On examination-She is thin built

Pallor +
Vitals-
PR - 70bpm, normal in volume, regular, no radio-radial or radio femoral delivery 
Bp - 100/70mmhg
Afebrile
Spo2 - 98% on Room air
RR - 20cpm
Systemic Examination- 
Per Abdomen - 
On Inspection: 
Distended 
Umbilicus everted
Palpation-
No tenderness
No palpable organomegaly 
Percussion -
Dull note present in all areas of the abdomen
Fluid thrill present
Bowel sounds present
CVS- S1,S2+
RS- Bilateral vesicular breath sounds +
CNS - Normal
INVESTIGATIONS-
CUE-
ECG-
CHEST X RAY
USG ABDOMEN-


2D ECHO-
CE CT ABDOMEN-

PROVISIONAL DIAGNOSIS
Ascitis secondary to ? Intestinal TB

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