58-year-old male complains of nonpainful, nonpitting edema in his left leg that started a month ago, a few days after he fell and hit the left side of his body. He claims to have stayed in the hospital for two weeks, during which several venous ultrasounds of his leg ruled out thrombosis and an ultrasound of his abdomen revealed signs of cirrhosis with portal hypertension (alcoholic; asymptomatic; mild lab abnormalities). Give your opinion.

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Varicose veins,needs elevation of limb,burgers exercise and tab. Stiloz 100ng bid for few weeks may lead to some improvement



? Vasculpathy.. ? Lymphangitis

What about hematological investigations nonspecific diagnosis is possible provisional diagnosis diabetic gangrene

Unilateral pitting oedema of leg is not due to systems disorder. May be Local infection Varicose vein with venous stasis Filarial oedema due to lymphatic obstruction Treatment To keep the leg elevated Avoid long standing Physical exerscises ankle exerscises Antibiotic broad spectrum Anti inflammatory Hetrazan may be given if seems to be filariasis To treat the underlying cause.

Elephantiasis dd lyumphangitis

Alcoholic liver chirossis with portal hypertension,with venous thrombosis in the leg

Angioneurotic oedema needs further hematological investigations. May be due vascular insufficiency

Chronic lymphangitis ? Filarial lymphatic obstruction. Lymphangiogram can be confirmative. Antibiotics, elevation of limb, chymoral, dimethyl carbamazepine citrate ( Hetrazan ) Treatment of cirrhosis liver with diuretics

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