47year male with pain abdomen

Case:
A 47year old male came with chief complaint of pain abdomen from 4days
History of present illness:
The patient was apparently asymptomatic 4days ago,then he developed pain in left hypochondrium,epigastrium which was sudden in onset ,gradual in progression, squeezing type ,no aggravating factors and relieved on vomiting
-He had 1episode of vomiting which is watery and bilious
-He has burning micurition 
-Fever from last 1 day
Past history:
-He is a known case of diabetes from 14 years and is on oral hyppoglycemic drugs.
-He is also known case of hypertension from 10 years
- He had a history of renal calculi 4 years ago and had undergone surgery

Personal history:
Appetite -normal
Diet-mixed
Sleep -Adequate
Having constipation from 1 dayand burning micurition from 4 days
He is a chronic alcoholic from last 25 years
Family history:
No similar complaint in family
General examination:
Pallor- absent
Icterus- absent
Cyanosis- absent
Clubbing- absent
Generalized lyphadenopathy- absent
Pedal oedema- absent
Vitals:
Temperature: febrile
BP: 140/90 mm of Hg
HR:97bpm
RR:18cpm
Abdominal examination
Inspection:
-shape of abdomen : distended
- Umbilicus- central
-All quadrants are moving equally on respiration
-no scars ,sinuses,visible pulsation ,engorged veins
Palpation:
Abdomen is tender and rigid
No hepatomegaly,no spenomegaly
Percussion:
Resonant
No fluid thrill,no shifting dullness
Auscultation: 
 Bowel sounds are heard
Respiratory examination:bilateral airentry present
Cvs examination: no murmurs
CNS examination: no focal neurological deficit
Investigation:
Serum amylase and lipase

USG:
ECG
Haemoglobin:15.2
TLC:10,600
PCV:46.5
AST:328
ALT:182
ALBUMIN :3.9
Treatment:
-Nothing by mouth(NBM)
-IV normal saline,ringer lactate @ 125 ml/ hr
- Inj.PAN 40 mg IV/BD
-Inj.zoffer 4mg IV/TID
-Inj.Tramadol 20mg IV/TID
Provisional diagnosis:
Acute on chronic pancreatitis with diabetes mellitus and hypertension



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