A middleaged man is admitted to the hospital after he is fou

A middle-aged man is admitted to the hospital after he is found passed out on a sidewalk near a bar. He is slightly jaundiced (yellowed skin and eyes and elevated bilirubin levels). Both his liver and spleen are enlarged (hepatomegaly and splenomegaly) on palpation, and the abdomen is fluid-filled (ascites). Engorged varicose veins are present around his umbilicus, and a rectal exam reveals internal hemorrhoids. When the man awakens he vomits, and the vomit contains bright red blood. 1. What is your diagnosis to explain the patient\'s symptoms? 2. How do you explain the enlargement of the spleen? 3. How do you explain the ascites? 4. How do you explain the enlarged veins in the abdomen and rectum? 5. Why did the patient vomit blood?

Solution

1. The patient is having symptoms like yellow eyes and skin that indicate the jaundice. The liver and spleen are enlarged. The abdomen is accumulated with fluids and can be known by palpation. Varicose veins are observed around umbilicus and hemorrhoids are observed by rectal examination. The patient vomitted blood.

2. Spleen enlargement is explained by the term spleenomegaly. The term spleen/o/megaly contains combining form spleen/o referred to spleen and the suffix -megaly means enlargement.

3. Ascites is explained by fluid accumulation in the abdomen. Palpation of abdomen indicates the accumulation of fluid or ascites.

4. The enlarged veins in abdomen are explained by varicose veins around umbilicus. Enlarged veins in rectum are explained by the term hemorrhoids.

5. Patient is suffering with Jaundice. In this condition, excess bile pigments are accumulated in the blood and they cause nausea and vomitting. Since, the patient is suffering with multiple conditions of jaundice, hepatomegaly, spleenomegaly and ascites, nausea forced him to vomit and tearing of tissues during vomitting might had lead to presence of blood in the vomit.