Federal University

It is important to detach that the carried through analysis is product of collective quarrel of the authors under gide of the knowledge acquired throughout its graduations developed in the Federal University of the Paraba.Caso clnicoDocente of 48 years, masculine, white, bachelor, professor, natural of Sousa (PB), resident in Joo Pessoa (PB), that it looked clinical attendance for renal treatment of litase. To the clinical examination the same it told anorexy symptoms, asthenia, nauseas, vomits, emagrecimento and abdominal pains in clica, especially in the right hipocndrio, it has 1 year approximately. It denied sudorese, calafrios, prurido and alterations in the intestinal habit. It relates antecedents familiar of cancer, diabetes mellitus, coronariana illness, alcoholism, tobaccoism. It told to be tabagista (40cigarros/dia) and with etlicos habits (320 g) it has 18 years. The patient qualitatively presented quantitative reduced diet and in relation the proteins, staple fibres, vitamins and you leave minerals on average, carrying through only two daily meals.

To the physical examination, the patient presented itself in eupnico, anictrico, aciantico, afebril state general regular, corado, hidratado. They had been proven: telangiectasias (tero superior of the thorax and neck), eritema to palmar and to plant, digital, ginecomastia hipocratismo and esclerite. He was normotenso (PA=120/80mmHg), without cardiorrespiratrias alterations, with neurological alterations (marches to cerebelar and amnesia of setting and mandate) and psychic (sleepiness, lethargy). To the abdominal examination it presented abdome globoso, absence of collateral circulation, hepatomegalia (concrete liver the 2 cm of the right and painful costal rim to the palpao), signal of negative Murphy.