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Thirty five years old lady has been chronically ill. She is brought to the casualty department with haematemesis and malaena. She looks pale and is drowsy. She has got multiple bruises over the skin and has flapping tremor the hands. Abdominal examination reveals moderate splenomegaly, decreased hepatic dullness and shifting dullness is also present.

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Clinical Case of the Week.
By Dr. Adil Ramzan
Medicotips.com

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