Chronic Liver Disease ( CLD )
📅 Published on: July 18, 2024 | 🔄 Updated on: July 18, 2024
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Summary
| Diagnosis | Sex | Age |
|---|---|---|
| Umbilical Hernia With Skin Necrosis and Acsitic Leak | Female | 18 |
| Nationality | Admission date | Discharge date |
| Indian | April 4, 2024 | April 8, 2024 |
Detailed Information
CHIEF COMPLAINT:
c/o abdominal swelling along with ascites and leaking fluid. c/o skin itching all over body and T2DM associated with diabetic neuropathy.
PRESENTING ILLNESS:
A 49-year-old female k/c/o diabetes, cirrhosis of the liver with portal hypertension NASH related, MELD score 16, non-bleeding grade -III oesophageal varices, ascites, splenomegaly, now presented with c/o Abdominal swelling – leaking fluid which is associated with abdominal distension and pedal oedema. No features of obstruction, fever, Gl bleed, or altered sensorium. P/A: umbilical swelling necrosis present, leaking free fluid. On UGIE (09-12-2023): Grade II/III Oesophageal varices. On CECT Abdomen (11-12-2023): umbilical defect 2.8cm, CLD, Splenomegaly, Ascites. Conservative medicinal treatment is going on.
Now The patient along with her son and DIL has come to get her CLD (NASH-related) treated by experimental stem cell therapy. She and her son & DIL have been explained about the status of stem cell therapy in India about its experimental nature & they all have agreed voluntarily to undergo this experimental stem cell therapy.
Written informed consent was taken and the same has been explained in their understandable language by the treating stem cell therapy consultant.
PAST MEDICAL HISTORY:
T2DM since 2020 & taking injections hum insulin on a regular basis. Also, she had CLD with portal hypertension.
FAMILY HISTORY:
No h/o major illness in the family.
PLAN OF ACTION:
Stem Cell therapy
Exosome Injection
Injection Lasix 2gm stat
Injection Monocef 1gm stat
IV RL 250ml
OPERATION UNDERTAKEN/PROCEDURE:
1. Stem cells + Exosome growth proteins given through intravenous route.
2. Inj Monocef 1gm stat & Inj Pan40mg stat
3. IV RL given slowly.
4. Nebulisation with combi-mist-L Respules 2.5ml
IN THE COURSE OF HOSPITAL AND COMPLICATION IF ANY:
The patient admitted with the above-mentioned complaints and evaluated with blood investigations. The patient managed with IVF, analgesics, antibiotics, and other supportive measures. The physician’s (Dr. Pankaj Kumar) opinion taken and advice followed. The Patient and attendants have been counselled regarding stem cell therapy and its current experimental status in India. They are willing for the non-invasive option of Rx as stem cell therapy. So patient was planned for optimization. Regular albumin infusions had been done this week on Monday before they planned to visit us here at Delhi NCR.
On day 1, the Patient was clinically examined and thoroughly investigated, the physician’s opinion taken, and informed written consent taken. As patient was having a fever of grade 104°F, an IV injection of Monocef 1gm and Injection Pacimol gm was given via IV as stat dose. In the evening, she has been given I/v Stem cells + Exosome GFs by taking aseptic precautions. Post-procedure was uneventful (no headache or vomiting). All vitals settled down with GC stable. The patient was afebrile, conscious, and well-oriented.
On day 2nd, as the patient was having Hypotension, as per the physician’s advice, she has been started with IV RL. which helped to regain her blood pressure by 100/68mm of Hg. Diet consultation was given to her along with the attendants. She has been given diuretics and ascitic tapping advised. Regular wound dressings done.
On 3rd day morning, at the time of discharge, she is clinically stable. The patient improved symptomatically, tolerating orally, and discharged under stable conditions. She has been advices for ascitic tapping. Regular wound dressings done.
