|
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| Line 1: |
Line 1: |
| <span style="font-size:85%">'''Abbreviations:'''
| |
| '''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''IV'''= Intravenous, '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CXR'''= Chest X ray, '''IgA'''= [[Immunoglobulin A]], '''IgG'''= [[Immunoglobulin G]], '''IgM'''= [[Immunoglobulin M]], '''CT'''= [[Computed tomography]], '''[[PMN]]'''= Polymorphonuclear cells, '''[[ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[CRP]]'''= [[C-reactive protein]], TS= [[Transferrin saturation]], SF= Serum [[Ferritin]], SMA= [[Superior mesenteric artery]], SMV= [[Superior mesenteric vein]], ECG= [[Electrocardiogram]]</span>
| |
|
| |
|
| {| align="center"
| |
| |-
| |
| |
| |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| | colspan="13" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations'''
| |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis
| |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms'''
| |
| ! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Acute suppurative cholangitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *Abnormal [[LFT]]
| |
| *WBC >10,000
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows [[biliary]] dilatation/stents/tumor
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Septic shock occurs with features of [[SIRS]]
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Cholangitis|Acute cholangitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Abnormal [[LFT]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows [[biliary]] dilatation/stents/tumor
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Biliary drainage ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) + IV antibiotics
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute cholecystitis|Acute cholecystitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Hyperbilirubinemia]]
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound shows:
| |
| * Gallstone
| |
| * Inflammation
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Murphy's sign|Murphy’s sign]]
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute pancreatitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased [[amylase]] / [[lipase]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows evidence of [[inflammation]]
| |
| * CT scan shows severity of pancreatitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Pain radiation to back
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chronic pancreatitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased [[amylase]] / [[lipase]]
| |
| * Increased stool fat content
| |
| * Pancreatic function test
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
| |
| * Calcification
| |
| * Pseudocyst
| |
| * Dilation of main pancreatic duct
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Predisposes to pancreatic cancer
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pancreatic carcinoma]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ↑ [[Alkaline phosphatase]]
| |
| * ↑ [[Bilirubin|serum bilirubin]]
| |
| * ↑ [[gamma-glutamyl transpeptidase]]
| |
| * ↑ [[CA 19-9]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Computed tomography|MDCT]] with [[Positron emission tomography|PET]]/[[Computed tomography|CT]]
| |
| * MRI
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| [[Skin]] manifestations may include:
| |
| * [[Bullous pemphigoid]]
| |
| * [[Mucous membrane pemphigoid|Cicatricial pemphigoid]]
| |
| * [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]])
| |
| * [[Panniculitis|Pancreatic panniculitis]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary biliary cirrhosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]/[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased AMA level, abnormal [[LFTs]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ERCP
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Pruritis
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary sclerosing cholangitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased liver enzymes
| |
| * Increased [[IgM]], [[IgG]]4
| |
| * [[Anti-neutrophil cytoplasmic antibody]] ([[p-ANCA]])
| |
| * [[Anti-nuclear antibody]] ([[ANA]])
| |
| * [[Anti-smooth muscle antibody]] (Anti-Sm)
| |
| * Anti-endothelial antibody
| |
| * Anti-cardiolipin antibody
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |ERCP and MRCP shows
| |
| * Multiple segmental [[strictures]]
| |
| * Mural irregularities
| |
| * [[Biliary]] dilatation and diverticula
| |
| * Distortion of biliary tree
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * The risk of [[cholangiocarcinoma]] in patients with primary sclerosing cholangitis is 400 times higher than the risk in the general population.
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cholelithiasis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]/[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal to hyperactive for dislodged stone
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows [[gallstone]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Fatty food intolerance
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastrointestinal perforation]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive/hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * WBC> 10,000
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Air under [[diaphragm]] in upright [[CXR]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Hamman's sign]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Inflammatory bowel disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Anti-neutrophil cytoplasmic antibody]] ([[P-ANCA]]) in [[Ulcerative colitis]]
| |
| * [[Anti saccharomyces cerevisiae antibodies]] (ASCA) in [[Crohn's disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[String sign]] on [[abdominal x-ray]] in [[Crohn's disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| Extra intestinal findings:
| |
| * [[Uveitis]]
| |
| * [[Arthritis]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Whipple's disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Thrombocytopenia]]
| |
| * [[Hypoalbuminemia]]
| |
| * [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis.
| |
| Images used to find complications
| |
| *[[Whipple's disease x ray|Chest and joint x-ray]]
| |
| *[[Whipple's disease CT|CT]]
| |
| *[[Whipple's disease MRI|MRI]]
| |
| *[[Whipple's disease ultrasound|Echocardiography]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
| |
| * [[Uveitis]]
| |
| * [[Endocarditis]]
| |
| * [[Encephalitis]]
| |
| * [[Dementia]]
| |
| * [[Hepatosplenomegaly]]
| |
| * [[Arthritis]]
| |
| * [[Ascites]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|Viral hepatitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in Hep A and E
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in fulminant hepatitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in acute
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Abnormal LFTs
| |
| * Viral serology
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Hep A and E have fecal-oral route of transmission
| |
| * Hep B and C transmits via blood transfusion and sexual contact.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CBC
| |
| * Blood cultures
| |
| * Abnormal [[Liver function test|liver function tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| * CT
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatocellular carcinoma]]/Metastasis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Normal
| |
| * Hyperactive if obstruction present
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * High levels of [[Alpha-fetoprotein|AFP]] in serum
| |
| * Abnormal [[Liver function test|liver function tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| * CT
| |
| * Liver biopsy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| Other symptoms:
| |
| * [[Splenomegaly]]
| |
| * [[Variceal bleeding]]
| |
| * [[Ascites]]
| |
| * [[Spider nevi]]
| |
| * [[Asterixis]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Budd-Chiari syndrome|Budd-Chiari syndrome]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in liver failure leading to varices
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *Elevated [[Aspartate aminotransferase|serum aspartate aminotransferase]] and [[alanine aminotransferase]] levels may be more than five times the upper limit of the normal range.
| |
| *Elevated serum [[alkaline phosphatase]] and [[Bilirubin|bilirubin levels]], decreased [[Albumin|serum albumin level]].
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Findings on [[CT scan]] suggestive of Budd-Chiari syndrome include:
| |
| *Early enhancement of the [[caudate lobe]] and [[central liver]] around the [[Inferior vena cavae|inferior vena cava]]
| |
| *Delayed enhancement of the peripheral [[liver]] with accompanying central low density (flip-flop appearance)
| |
| *Peripheral zones of the [[liver]] show reversed [[portal]] [[venous]] [[blood flow]]
| |
| *In the [[chronic]] phase, there is [[caudate lobe]] enlargement and [[atrophy]] of the [[Liver|peripheral liver]] in affected areas
| |
| |}
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Ascitic tap|Ascitic fluid examination]] shows:
| |
| *[[Total protein]] more than 2.5 g per deciliter
| |
| *[[White blood cells]] are usually less than 500/μL.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cirrhosis|Cirrhosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Hypoalbuminemia]]
| |
| * Prolonged PT
| |
| * Abnormal LFTs
| |
| * [[Hyponatremia]]
| |
| * [[Thrombocytopenia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |US
| |
| * Nodular, shrunken liver
| |
| * [[Ascites]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Stigmata of liver disease
| |
| * Cruveilhier- Baumgarten murmur
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Spontaneous bacterial peritonitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in cirrhotic patients
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ascitic fluid [[PMN]]>250 cells/mm<small>³</small>
| |
| * Culture: Positive for single organism
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound for evaluation of liver cirrhosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Biliary colic]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ↑ [[bilirubin]] and [[alkaline phosphatase]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| |}
| |
| |}
| |