Acute Episode in Pre-Diagnosed Case of Pancreatic Ascites with Pancreatic Duct Leak
Very High Serum Amylase - 2240 IU/L (Normal -35 to 145 IU/L)
ERCP Report - Ascites due to PD Leak, PD could not be visualized beyond the site of leak
Ascitic Fluid Amylase - > 30,000 IU/L
Considering Intensity, Mortality & Morbidity
Acute Pancreatitis ≈ Ca Head of Pancreas
Considering Intensity, Mortality & Morbidity Acute Pancreatitis ≈ Ca Head of Pancreas Patient approached
HOMOEOPATHIC CANCER CARE CENTRE on 7th Sept 2005
Excruciating pain in epigastric region - Radiating to Back - Not responding to analgesics & even Sedatives
Breathlessness worsening least exertion, Difficult movements due to ? Pain / ? Fatigue
Frequent, loose, mucoid, dark blackish, offensive ++ stools ( Such stools indicate internal bleeding)
Significant weight loss - 12 kg over 4 mths.
CT Scan -Huge Ascites with Pancreatic Duct leak + Left Pleural Effusion.
Tachycardia & Hypotension (↑↑Heart Rate, ↓↓B.P.)
Appetite, Thirst - was lost, Sleeplessness due to severe pain.
Abdominal Girth in standing position was 76 cm due to Ascites - 7th Sept 2005
Bad Prognostic Criteria
( All covered by this Patient )
Grading as per Severity Index
Grade IV - Pancreatitis
( 2 or more Peri pancreatic fluid collections )
••Ascites S. Amylase
Left Pleural Effusion 2240 IU / L
( Ref. :- Harrison's Principles of Internal Medicine )
Patient was prescribed only one single Homoeopathic Medicine strictly as per Guidelines & Principles of Homoeopathy & was observed daily in Clinic
Patient was feeling a bit comfortable although the intensity of complaints was almost same
C/o - Lightening pain-Left mid axillary line
Spasmodic pain in epigastrium, more in evening time, temporary relieved after eating.
Breathlessness, increasing after exertion
Sticky Salivation with Thirst less ness.
Much better in General for 1 day, again complaints increased...
Persistent pulling pain in Epigastrium & below ribs
Burning pain in Abdomen more at night, Relieved after eating
( Most important from Homoeopathic point of view - which indicates that direction of treatment is right)
Urinary Output↑↑, Appetite↑↑, Thirst ↑ a bit, Sleep - much comfortable
Breathlessness & Fatigue ↓↓
Stools, Ascites & Oedema on Legs - Same, No Change.
USG Abdomen - Moderate to Gross Ascites
As Patient was improving symptomatically but pathology was unchanged we Reconsidered our Prescriptions & necessary changes in the Medication were done...
Much well in General, Pain Subsided ( which did not respond to analgesics & even sedatives in the past )
Stools improved - indicates control over internal bleeding
Appetite, Thirst, Sleep & Weakness - Improvement maintained
Ascites Reduced - Abdominal Girth - 69cm, Weight loss 1.5 kg indicating weight of Ascitic fluid.
|7th Sept 2005||17 Sept 2005|
Much well -mild pain in epigastrium increasing at 3am & 4pm
Abd. Girth ↓↓ - 66.5 cm
USG Abd. - Moderate Ascites
Mild pain in epigastrium - off & on
S. Amylase ↓↓ -141 IU / L ( Previously 2240 IU/L )
Patient is now living Absolutely Normal Life without any dietary restrictions
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