A 32 year old female, delivered 14 months back, presented with
progressive abdominal distension, abdominal discomfort and fever of 10 days
duration, with past history of admission in a general hospital for 1 month,
with complaints of pain right upper abdomen and jaundice. Examination revealed
fever, tachycardia and melasma .She had a distended abdomen with sriae and
visible veins on both flanks, hepatomegaly and fluid thrill. Rest of the
examination was unremarkable. Investigations revealed anemia (normochromic,
normocytic) with high ESR. In liver function , she had increased bilirubin and
transaminases and hypoalbuminemia. Ascitic fluid analysis showed
neutrophillic,culture negative and low SAAG ascites. Abdominal imaging showed
hepatic vein thrombosis extending into inferior vena cava with collaterals.
Coagulation profile showed Protein C and Protein S deficiency.see more
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