65 years well-educated male, suffering from DM Type 2, for last 8 to10years, has presented with pain right hypochondrium with radiation to both upper and lower limbs, having frequent headache for last eight to nine months, excruciating pain, more postprandial and pain starts as soon as he goes to sleep or takes an afternoon nap. Fear of pain and discomfort keep him awake and has become very depressed and apprehensive. Diabetes is under control. Has documented peripheral neuropathy. Taking glimepiride 1mg. with good control. Gabapentin and multivitamins regularly.
Taking Telmisartan for hypertension and has kept the BP under control. The bowel is regular, twice in a day. Appetite normal and no postprandial fullness or discomfort. Investigations: Chest skiagram: Normal and no parenchymal active lesson. USG ABD, twice and has a right renal cyst. CRP, ESR, CBC, LFT, RFT, Haemogram,…
