43 yr old male with abdominal pain

This is an online e-log book to discuss our patient de-identified health data shared after taking his / her / guardian's signed informed consent. Here we discuss our individual patients' problems through a series of inputs from the available global online community of experts with an aim to solve those patients' clinical problems with collective current best evidence-based information.

This E blog also reflects my patient-centered online learning portfolio and your valuable input in the comment box is welcome.

I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations, and coming up with diagnosis and treatment plans. is an online e-log book to discuss our patient's de-identified health data shared after taking his / her / guardians' signed informed consent. Here we discuss our individual patients' problems through a series of inputs from the available global online community of experts with an aim to solve those patients' clinical problems with collective current best evidence-based information.


A 43 yr old male came to hospital with c/o
Fever since 7 days
Diffuse abdominal pain since 6 days
Patient was apparently asymptomatic 7 days back then he developed low grade fever, insidious in onset gradually progressive, associated with pain abdomen initially in Right hypochondriac region which gradually became diffuse
H/o decreased urine output
No h/o burning micturition, vomiting, loose stools, constipation
Past: no similar complaints in past, n/k/c/o dm, htn, asthma, tb, epilepsy
Personal: Sleep and appetite are normal, Bowel and bladder regular, 
Family: no similar complaints in family
On examination
Abdomen is flat, all quadrants moving equally with inspiration. No visible sinuses, scars, fistula. Engorged veins are seen
On palpation: abdomen is rigid, no local rise of temperature, tenderness present in Right hypochondrial region
Percussion: Resonant note is heard in periumbelical region in supine position. Shifting dullness 

Usg abdomen: poorly liquefied abscess noted in segment VI and VII with signs of subcapsular rupture. Mild to moderate ascitis

     17/01/24
    18/01/24 morning
    18/01/24 evening
    19/01/24

     17/01/24
     18/01/24
     19/01/24

Diagnosis : acute on chronic pancreatitis

Diagnostic laproscopy was done and multiple adhesions were cleared. A pus pocket containing approximately 300ml of Pus was drained. Liver, spleen and bowel were cosualised. 3 drained were placed for further drainage of ascitic fluid

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