A 40yr old male came to opd with yellowish discoloration of eyes

A 40 yr old male came to opd with 
CHIEF COMPLAINTS : yellowish discoloration of eyes and nails since 1 month
Abdominal distension since 4days
HOPI: Patient was apparently asymptomatic 1 mnth ago then he developed yellowish discoloration of scelra and nails beds which was insidious in onset,gradually progressive,first he noticed on sclera then over nail beds not associated with itching of skin,pale stools.
Abdominal distension which was insidious in onset, gradually progressive,diffuse type associated with shortness of breath(insidious , gradually progressive,grade 2 )no h/o orthopnea,PND,sweating, palpitations,chest pain
No h/o nausea,vomitings,joint pains, fatigue, burning micturition.
PAST HISTORY: no history of similar complaints in the past.
No h/o DM,HTN, epilepsy,asthma,TB
NO history of blood transfusion
PERSONAL. HISTORY:
Diet- mixed
Appetite -normal
Sleep-adequate
Bowel n bladder - normal
Addictions- alcoholic since 20 yrs (90ml/day)
Abstinence since 2 mnths
FAMILY HISTORY : not significant
GENERAL EXAMINATION:
Pt is conscious/coherent/coperative,well oriemted to time place person..moderately built, moderately nourished
Pallor- absent
Icterus-present
Cyanosis-absent
Clubbing-absent
Pedal edema-grade 2 type of pitting edema below knee
Lymphadenopathy- absent
SYSTEMIC EXAMINATION:

ABDOMINAL EXAMINATION
Inspection:
Shape:distended
Flanks-full
No scars,no sinuses,no engorged veins
No dilated veins,no spider nevi
PALPATION:
No local rise of temperature,no tenderness
No splenomegaly,no hepatomegaly
PERCUSSION:
liver span:9cm
Shifting dullness - positive
Fluid thrill-negative
Puddle sign - positive
AUSCULTATION:
Bowel sounds heard
PROVISIONAL DIAGNOSIS:
Decompensated chronic liver disease




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