Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of known Polycystic Liver and Kidney Disease (PLKD). Reports [stable/worsening] abdominal distension, early satiety, and dull RUQ/flank pain. Denies hematuria, fever, or signs of cyst infection. Current renal function is [stable/declining]. No history of intracranial aneurysm rupture or diverticulitis.
Clinical Examination Findings
Abdomen: Distended, non-tender to palpation, but with palpable hepatomegaly and bilateral flank masses consistent with polycystic organomegaly. Bowel sounds present. No guarding or rebound tenderness. Cardiovascular: Regular rate and rhythm, no murmurs. Blood pressure: [Insert BP] mmHg. Extremities: No peripheral edema.
Treatment Protocol
Management plan: 1. Monitor renal function (Cr, GFR) and liver enzymes every [X] months. 2. Blood pressure control with [ACEi/ARB] to target <130/80 mmHg. 3. Pain management: Avoid NSAIDs; consider acetaminophen or nerve blocks if indicated. 4. Referral to Nephrology/Hepatology for potential cyst aspiration or surgical intervention if symptomatic mass effect occurs.