Abdominal Pain

Hypotheses

A 55 year old accountant with acute abdominal pain

History

A patient is brought to the emergency room with acute abdominal pain. His ID indicates he is a 55 year old accountant. He appears un-kept with poor body hygiene that masks any other odour. His abdomen is soft but diffusely tender, distended with ascites; there are no signs of a localized pain or guarding.

 

Laboratory findings 

  • high blood alcohol concentration (BAC; 250 mg/dcl), with no other symptoms of intoxication. 

  • Patient is febrile, with WBC 17,000; platelets 50k (normal >150k).

Other findings out of normal range: 

  • INR (International Normalized Ratio, a measure of the state of coagulation) is 3 (normal 1 or below); 
  • prothrombin time (PT) is 25 (normal < 13). 
  • Hepatic enzymes are elevated (AST > ALT) without cholestatic picture.

 

 

What is the likely reason for the patient's state?