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A 72-year-old man who is under the haematologists for polycythaemia

72 years old | Male

Vignette:

A 72-year-old man who is under the haematologists for polycythaemia rubra vera presents to the emergency department with a 2-day history of abdominal pain. On examination he is mildly jaundiced and there are no signs of chronic liver disease but he has a painful enlarged liver with moderate ascites.

Summary:

polycythemia rubra vera | 2 days | abdominal pain | jaundiced | enlarged liver | painful liver | ascites

Dx:

Budd–Chiarisyndrome

Ref:

ccu hepatology MCQ 15 page 170

Rank

Disease

Weight

1 Alcoholic hepatitis 305.0
2 Liver Cirrhosis 290.0
3 Budd Chiari Syndrome 286.0
4 Alcoholic Liver Disease 280.0
5 Autoimmune hepatitis 276.0
6 Biliary cirrhosis 275.0
7 Common cutaneous drug reactions 272.0
8 Cholangiocarcinoma 267.0
9 Tuberculous Peritonitis 262.0
10 Primary sclerosing cholangitis 260.0
11 pancreatic cancer 259.0
12 Hepatocellular carcinoma 233.0
13 Primary biliary cirrhosis 225.0
14 Hereditary hemochromatosis 220.0
15 Pyogenic Liver Abscess 216.0
16 Amebic Liver Abscess 212.0
17 Alcoholic Liver Cirrhosis 207.0
18 Chronic heart failure 198.0
19 Liver disease 196.0
20 Biliary cyst 187.0
21 Mesenteric ischemia 179.0
22 Acute Cholangitis 167.0
23 Acute intermittent porphyria 165.0
24 Klebsiella pneumoniae liver abscess 164.0
25 Alcoholic Fatty Liver 161.0
26 Acute Hepatitis 160.0
27 Acute Liver Failure 155.0
28 Wilson disease 152.0
29 Gallbladder cancer 143.0
30 Acute Appendicitis 142.0
31 Toxic Megacolon 139.0
32 Hepatorenal Syndrome 139.0
33 Psoas Abscess 136.0
34 Intestinal Obstruction 134.0
35 Hereditary Angioedema 133.0
36 Sigmoid volvulus 129.0
37 Non-alcoholic Fatty Liver Disease 128.0
38 Chronic Pancreatitis 126.0
39 Acetaminophen overdose 126.0
40 Acute Clonorchiasis 125.0
41 chronic acalculous cholecystitis 125.0
42 Sarcoidosis 125.0
43 Choledochal Cyst 124.0
44 Ovarian Cancer 119.0
45 Shigellosis 117.0
46 Acute Lymphoblastic leukemia in children 117.0
47 Acute fatty liver of pregnancy 114.0
48 Adrenal crisis 112.0
49 Acute pyelonephritis in adults 112.0
50 Primary Myelofibrosis 111.0
51 subserosal eosinophilic gastroenteritis 110.0
52 Malaria 110.0
53 Peritoneal dialysis associated peritonitis 109.0
54 Gastric Volvulus 108.0
55 Spontaneous bacterial peritonitis 107.0
56 Colorectal cancer 107.0
57 Renal Cell Carcinoma 106.0
58 Hemolytic uremic syndrome 106.0
59 Zollinger-Ellison Syndrome 104.0
60 Endometriosis 104.0
61 Dubin-Johnson syndrome 104.0
62 Acute peptic ulcer 100.0
63 Intussusception 100.0
64 Anthrax 100.0
65 Extraintestinal Entamoeba histolytica amebiasis 100.0
66 Chronic liver disease 100.0
67 Acute Cholecystitis 99.0
68 mucosal Eosinophilic gastroenteritis 99.0
69 Autosomal Dominant Polycystic Kidney Disease 98.0
70 Giardiasis 98.0
71 Anemia of chronic disease 98.0
72 Liver Abscess 98.0
73 Chronic Clonorchiasis 97.0
74 Crohn Disease 95.0
75 Acalculous Cholecystitis 95.0
76 Bacterial gastroenteritis 95.0
77 Emphysematous cholecystitis 95.0
78 Listerial gastroenteritis 95.0
79 Eosinophilic gastroenteritis 94.0
80 Muscle Layer Eosinophilic gastroenteritis 94.0
81 Gastric cancer 92.0
82 Acute perforated appendicitis 92.0
83 Brucellosis 92.0
84 Chronic bacterial prostatitis 91.0
85 biliary SOD 90.0
86 Intestinal malrotation 89.0
87 Renal and perinephric abscess 87.0
88 Adrenocortical carcinoma 86.0
89 Ectopic Pregnancy 86.0
90 Ruptured ectopic pregnancy 86.0
91 Rotor syndrome 86.0
92 Food poisoning 85.0
93 Hyperprolactinemia 85.0
94 Ovarian Hyperstimulation Syndrome 84.0
95 Lactose intolerance 83.0
96 Inflammatory Bowel Diseases 83.0
97 Gallstones 83.0
98 Choledocholithiasis 83.0
99 Autoimmune Pancreatitis 83.0
100 Cystic Fibrosis 83.0
101 Typhoid infection 83.0
102 Short bowel syndrome 83.0
103 Thrombotic thrombocytopenic purpura 82.0
104 Non-ST-elevation myocardial infarction 82.0
105 Familial adenomatous polyposis syndrome 81.0
106 Acute Lymphocytic Leukemia in Adults 80.0
107 Esophagitis 80.0
108 Autosomal Recessive Polycystic Kidney Disease 80.0
109 Campylobacter infection 79.0
110 Churg-Strauss Syndrome 77.0
111 Irritable Bowel Syndrome 76.0
112 Acute peritonitis 76.0
113 Glomerulonephritis 76.0
114 Pulmonary Embolism 75.0
115 Peptic Ulcer 75.0
116 Chronic Hepatitis 75.0
117 Ruptured ovarian cyst 75.0
118 Aortic coarctation 75.0
119 Clonorchiasis 74.0
120 Rocky Mountain spotted fever 74.0
121 Kidney stones 71.0
122 Systemic sclerosis 70.0
123 Urinary Tract Obstruction 70.0
124 Mirizzi Syndrome 70.0
125 Clostridium difficile infection 69.0
126 Hypothyroidism 68.0
127 Addison Disease 67.0
128 Acute Renal vein thrombosis 65.0
129 Foodborne E coli infection 65.0
130 Gastrointestinal Hemorrhage 65.0
131 Lower gastrointestinal hemorrhage 65.0
132 Upper gastrointestinal hemorrhage 65.0
133 Ruptured Tuboovarian abscess 64.0
134 Anaphylaxis 63.0
135 Intrahepatic Cholestasis 63.0
136 Intestinal Pseudo Obstruction 62.0
137 Acute bacterial meningitis in children 61.0
138 Acute Pancreatitis 61.0
139 Gallstone pancreatitis 61.0
140 Pyelonephritis 61.0
141 Ileus 60.0
142 Kawasaki disease 60.0
143 Eclampsia 60.0
144 Intestinal Entamoeba histolytica amebiasis 60.0
145 Meckel diverticulum 60.0
146 Panic disorder in adults 59.0
147 Extrahepatic Cholestasis 59.0
148 Gastroenteritis 59.0
149 Non-small cell lung cancer 58.0
150 Diverticulitis 58.0
151 Umbilical hernia 58.0
152 Pelvic inflammatory disease 57.0
153 Acute pelvic inflammatory disease 57.0
154 Infectious mononucleosis 57.0
155 Lung Cancer 56.0
156 Ulcerative Colitis 56.0
157 Aortic Dissection 56.0
158 Mitral Stenosis 56.0
159 Duodenal Ulcer 55.0
160 Gastric Ulcer 55.0
161 Acute Myeloid Leukemia in children 55.0
162 Diabetic Ketoacidosis 54.0
163 Peutz-Jeghers Syndrome 54.0
164 Hypertriglyceridemia 54.0
165 Pancreatic Pseudocyst 53.0
166 Intraperitoneal bleeding 53.0
167 Intra-abdominal abscess 53.0
168 Hepatic Encephalopathy 52.0
169 Foreign body ingestion 52.0
170 Acromegaly 52.0
171 Celiac Disease 51.0
172 Insect bites and stings 51.0
173 Deep venous thrombosis 50.0
174 Tuboovarian abscess 50.0
175 Bacterial pharyngitis 50.0
176 Pheochromocytoma 50.0
177 Breast Cancer 50.0
178 Cholestasis 50.0
179 Portal hypertension 50.0
180 Splenic Infarction 49.0
181 Annular pancreas 49.0
182 Pneumonia 49.0
183 Rheumatoid Arthritis 49.0
184 Graves Disease 48.0
185 Polyarteritis nodosa 47.0
186 Hyperosmolar Hyperglycemic state 47.0
187 Parkinson disease 46.0
188 Cholera 46.0
189 Viral Gastroenteritis 46.0
190 Granulomatosis with polyangiitis 45.0
191 Acute pericarditis 45.0
192 Salmonella infection 45.0
193 Fibromyalgia 44.0
194 pancreatic SOD 44.0
195 Chronic Renal vein thrombosis 43.0
196 Epiploic appendagitis 41.0
197 Chronic pelvic pain in women 41.0
198 Familial Mediterranean fever 40.0
199 Bladder Cancer 40.0
200 Urinary tract infection 40.0
201 Acute Cystitis(Men) 40.0
202 Cystitis 40.0
203 Multiple endocrine neoplasia 2B 40.0
204 Chronic Mitral regurgitation 40.0
205 Gallbladder Dyskinesia 39.0
206 Chronic Cholecystitis 39.0
207 Atopic dermatitis 39.0
208 Guillain-Barre syndrome 38.0
209 Rumination Syndrome 38.0
210 Chronic Lymphocytic Leukemia 38.0
211 Amebiasis 38.0
212 Gilbert syndrome 38.0
213 Gastroparesis 36.0
214 Acute viral meningitis 36.0
215 Chronic Myeloid Leukemia 36.0
216 Bullous pemphigoid 36.0
217 Acute heart failure 36.0
218 Prostatitis 36.0
219 Chronic prostatitis 36.0
220 Globus Sensation 36.0
221 Heparin-induced thrombocytopenia 35.0
222 Leiomyomas 35.0
223 Abdominal compartment syndrome 34.0
224 Endometritis 34.0
225 Hyperthyroidism 34.0
226 Chronic Kidney Diseases 34.0
227 Ovarian and fallopian tube torsion 34.0
228 Adrenal Suppression 34.0
229 Blepharitis 34.0
230 Diabetic Amyotrophy 33.0
231 Acute Myeloid Leukemia in adults 32.0
232 Ascites 32.0
233 Multiple endocrine neoplasia 2A 32.0
234 Inguinal hernia 31.0
235 Intrahepatic cholestasis of pregnancy 31.0
236 COVID19 30.0
237 Gastric Outlet Obstruction 30.0
238 Analgesic nephropathy 30.0
239 Acne fulminans 30.0
240 Systemic lupus erythematosus 29.0
241 Multiple Myeloma 29.0
242 Amphetamine use disorder 28.0
243 Multiple Sclerosis 28.0
244 Abetalipoproteinemia 27.0
245 Peritonitis 26.0
246 Henoch-Schonlein purpura 26.0
247 Enterovesical fistula 26.0
248 Sphincter of Oddi Dysfunction 24.0
249 COPD Exacerbation 24.0
250 biliary colic 23.0
251 Acute Cystitis(Women) 23.0
252 Osteoarthritis 23.0
253 Renal vein thrombosis 23.0
254 Non-cholera Vibrio infections 23.0
255 Disseminated intravascular coagulation 23.0
256 Hiatus hernia 22.0
257 biliary obstruction 22.0
258 chronic biliary obstruction 22.0
259 Hypogammaglobulinemia 22.0
260 Chronic fatigue syndrome 21.0
261 Cholecystitis 21.0
262 Diabetes Mellitus 21.0
263 Hyperaldosteronism 21.0
264 Middle East respiratory syndrome 21.0
265 Dyspepsia 20.0
266 Preeclampsia 20.0
267 Exocrine pancreatic insufficiency 20.0
268 Vaginitis 20.0
269 Urethritis 20.0
270 Phimosis 20.0
271 Paraphimosis 20.0
272 Pityriasis rosea 20.0
273 Gout 19.0
274 Tinea versicolor 19.0
275 Secondary hyperparathyroidism 19.0
276 Endometrial cancer 18.0
277 Premature labor 18.0
278 Menopause 18.0
279 Chronic pyelonephritis 18.0
280 Acute bacterial meningitis in neonates 18.0
281 Amyloidosis 18.0
282 Carpal Tunnel Syndrome 18.0
283 Vulvovaginal candidiasis 17.0
284 Miliaria 17.0
285 Alzheimer disease 16.0
286 Splenic abscess 16.0
287 Splenic Rupture 16.0
288 Candidal intertrigo 16.0
289 ST-elevation myocardial infarction 15.0
290 Simple kidney cyst 15.0
291 Hypercalcemia 15.0
292 Obstructive Sleep Apnea 15.0
293 Ischemic stroke 15.0
294 Gastritis 14.0
295 Unstable angina 14.0
296 Systemic vasculitis 14.0
297 Stevens-Johnson syndrome 14.0
298 Herpes zoster 14.0
299 Hyperparathyroidism 13.0
300 Diabetic Neuropathy 13.0
301 Optic neuritis 13.0
302 Neuropapillitis 13.0
303 cholestatic liver disease 13.0
304 Milk-alkali syndrome 13.0
305 Acute Milk-alkali syndrome 13.0
306 Chronic Milk-alkali syndrome 13.0
307 Stable angina 12.0
308 Psychogenic polydipsia 12.0
309 Von willebrand disease 12.0
310 Alopecia areata 12.0
311 Secondary Peritonitis 11.0
312 Mallory-Weiss syndrome 11.0
313 Sunburn 11.0
314 Varicose veins 11.0
315 Gastroesophageal reflux disease 10.0
316 Cushing syndrome 10.0
317 Gestational diabetes mellitus 10.0
318 Acute atrial fibrillation 9.0
319 Renal Artery Stenosis 9.0
320 Medullary thyroid cancer 9.0
321 Fungal meningitis 9.0
322 chronic cholestatic liver disease 9.0
323 Keloid 9.0
324 Type 1 Diabetes mellitus 8.0
325 Acute Bacterial Prostatitis 8.0
326 Anaplastic thyroid cancer 8.0
327 Malt lymphoma 8.0
328 Primary ciliary dyskinesia 7.0
329 Kartagener syndrome 7.0
330 Graves ophthalmopathy 7.0
331 Epididymo-orchitis 6.0
332 Type 2 Diabetes mellitus 5.0
333 Bed bugs 5.0
334 Testicular cancer 5.0
335 Hemorrhagic stroke 5.0
336 Ankylosing spondylitis 4.0
337 Benign Prostatic Hyperplasia 4.0
338 Drowning 4.0
339 endocarditis 1.0
340 Hemorrhoids 0.0
341 Immune thrombocytopenia 0.0
342 Ovarian Torsion 0.0
343 Recurrent aphthous stomatitis 0.0
344 Discogenic low back pain 0.0
345 Acute epididymitis 0.0
346 Hodgkin lymphoma 0.0
347 Phenylketonuria 0.0
348 Stable ischemic heart disease 0.0
349 Pulmonary regurgitation 0.0
350 Acute disseminated encephalomyelitis 0.0
351 Bell palsy 0.0
352 Myoclonus 0.0
353 Androgenetic alopecia 0.0