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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29564
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My father n law was just admitted to the hospital with stomach

Resolved Question:

My father n law was just admitted to the hospital with stomach distention, fluid in his lungs and fluid around the sac of his heart. His legs are swollen as well. He has a long history of alcoholism. On top of everything else, he had his rights revoked and has been put under supervised care. My question is, howlong does he have to live? With and without care?
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
Greetings.

Has he a past episode of blood in vomiting?

Dr. Arun
Customer: replied 2 years ago.
Not that I know of, but his gums were bleeding and he is very jaundiced, along with his eyes buldging....
Expert:  Dr. Arun Phophalia replied 2 years ago.
Hello Robert,

I am sorry to hear about your father in law. His symptoms suggest advanced cirrhosis of liver (with liver failure). The life expectancy of individuals vary widely and an average life span with his symptoms would be 6 months or less, without care. The treatment of it is liver transplant, which can give significant life span, but with his present general condition and waiting period for it; that might not be feasible. Fluid collection in various parts of the body and deep jaundice are significant criteria for determining the prognosis of the alcoholic cirrhosis of liver. And as we discussed; the life span is around 6 months. But there are other factors too which determine the prognosis. This is called as Model for End-Stage Liver Disease (MELD) scoring system to assess the relative severity of patients' liver disease. Please read about them in these resources;

http://emedicine.medscape.com/article/185856-overview#aw2aab6c11


http://www.fpnotebook.com/gi/Exam/ChldPghScr.htm


These are slightly technical but if the other investigations related to liver are significantly deranged and he has altered consciousness off and on (encephalopathy); the prognosis would be far worse and life span can significantly be decreased further.

Please feel free for your follow up questions.

 

I would be happy to assist you further, if you need any more information.

 

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Thank you,

Customer: replied 2 years ago.
He doea have altered consciousness. Just started two days ago and when he awakes he babbles and makes no sense at along with being extremely combative (they had to knock him out and deem him unfit to make decisions for himself). Do hospitals have the ethical obligation to do everything possible to keep him alive if he/we cant make that decision for him? Fyi, its an odd situation, no one has medical power of attorney and he refused treatment, got combative and now he is unconscious.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Hello Robert,

With your description, his prognosis is poor. Altered consciousness point that waste products due to liver failure are affecting his brain (termed encephalopathy). This is poor prognostic sign. With no power of attorney; hospital has ethical obligation to provide him the available treatment. Though in his case treatment is more or less supportive and there is no definite treatment; as condition is progressive.

It is privilege assisting you.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29564
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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