Ischemic colitis physical examination: Difference between revisions

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{{Ischemic colitis}}
{{Ischemic colitis}}
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==Overview==
==Overview==
Ischemic colitis is characterized by [[abdominal pain]] which is out of proportion to physical findings, specifically excruciating abdominal pain despite limited focal tenderness.
Ischemic colitis is characterized by [[abdominal pain]] which is out of proportion to physical findings, specifically excruciating [[abdominal pain]] despite limited focal [[tenderness]], heme-positive rectal exam, and rebound tenderness if peritonitis is present.


==Physical Examination==
==Physical Examination==
The physical examination findings of ischemic colitis are as foloows:<ref name="TheodoropoulouΚoutroubakis2008">{{cite journal|last1=Theodoropoulou|first1=Αngeliki|last2=Κoutroubakis|first2=Ioannis E|title=Ischemic colitis: Clinical practice in diagnosis and treatment|journal=World Journal of Gastroenterology|volume=14|issue=48|year=2008|pages=7302|issn=1007-9327|doi=10.3748/wjg.14.7302}}</ref><ref name="pmid17071206">{{cite journal |author=Huguier M, Barrier A, Boelle PY, Houry S, Lacaine F |title=Ischemic colitis |journal=Am. J. Surg.|volume=192 |issue=5 |pages=679–84 |year=2006 |pmid=17071206 | doi=10.1016/j.amjsurg.2005.09.018}}</ref>
*The physical examination findings of ischemic colitis are as follows:<ref name="TheodoropoulouΚoutroubakis2008">{{cite journal|last1=Theodoropoulou|first1=Αngeliki|last2=Κoutroubakis|first2=Ioannis E|title=Ischemic colitis: Clinical practice in diagnosis and treatment|journal=World Journal of Gastroenterology|volume=14|issue=48|year=2008|pages=7302|issn=1007-9327|doi=10.3748/wjg.14.7302}}</ref><ref name="pmid17071206">{{cite journal |author=Huguier M, Barrier A, Boelle PY, Houry S, Lacaine F |title=Ischemic colitis |journal=Am. J. Surg.|volume=192 |issue=5 |pages=679–84 |year=2006 |pmid=17071206 | doi=10.1016/j.amjsurg.2005.09.018}}</ref>
* [[Abdominal pain]] in 77% of patients
 
* [[Abdominal tenderness]] in 21% of patients
*Physical examination of patients with ischemic colitis is usually remarkable for abdominal tenderness, heme-positive rectal exam, and rebound tenderness if peritonitis is present.
*Abdomen reveals mild to moderate tenderness over the affected area of the colon.
 
*Rectal examination shows heme-positive stools.
===Appearance of the Patient===
*Severe ischemia with transmural infarction and necrosis.
*Patients with ischemic colitis usually appear in apparent distress due to pain
**Marked abdominal tenderness with peritoneal signs.
 
===Vital Signs===
*[[Tachycardia]] with regular pulse
*Tachypnea
 
===Skin===
* Skin examination of patients with ischemic colitis is usually normal
 
===HEENT===
* HEENT examination of patients with ischemic colitis is usually normal
 
===Neck===
* Neck examination of patients with ischemic colitis is usually normal
 
===Lungs===
* Pulmonary examination of patients with ischemic colitis is usually normal
 
===Heart===
* Cardiovascular examination of patients with ischemic colitis is usually normal
 
===Abdomen===
*[[Abdominal distention]]  
*[[Abdominal tenderness]] over the affected area of bowel
*[[Rebound tenderness]] present if there is peritonitis
*Increased [[Intestine|bowel]] sounds
 
===Back===
* Back examination of patients with ischemic colitis is usually normal
 
===Genitourinary===
* Genitourinary examination of patients with ischemic colitis is usually normal
 
===Neuromuscular===
* Neuromuscular examination of patients with ischemic colitis is usually normal
 
===Extremities===
* Extermities examination of patients with ischemic colitis is usually normal


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 14:34, 5 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Ischemic colitis is characterized by abdominal pain which is out of proportion to physical findings, specifically excruciating abdominal pain despite limited focal tenderness, heme-positive rectal exam, and rebound tenderness if peritonitis is present.

Physical Examination

  • The physical examination findings of ischemic colitis are as follows:[1][2]
  • Physical examination of patients with ischemic colitis is usually remarkable for abdominal tenderness, heme-positive rectal exam, and rebound tenderness if peritonitis is present.

Appearance of the Patient

  • Patients with ischemic colitis usually appear in apparent distress due to pain

Vital Signs

Skin

  • Skin examination of patients with ischemic colitis is usually normal

HEENT

  • HEENT examination of patients with ischemic colitis is usually normal

Neck

  • Neck examination of patients with ischemic colitis is usually normal

Lungs

  • Pulmonary examination of patients with ischemic colitis is usually normal

Heart

  • Cardiovascular examination of patients with ischemic colitis is usually normal

Abdomen

Back

  • Back examination of patients with ischemic colitis is usually normal

Genitourinary

  • Genitourinary examination of patients with ischemic colitis is usually normal

Neuromuscular

  • Neuromuscular examination of patients with ischemic colitis is usually normal

Extremities

  • Extermities examination of patients with ischemic colitis is usually normal

References

  1. Theodoropoulou, Αngeliki; Κoutroubakis, Ioannis E (2008). "Ischemic colitis: Clinical practice in diagnosis and treatment". World Journal of Gastroenterology. 14 (48): 7302. doi:10.3748/wjg.14.7302. ISSN 1007-9327.
  2. Huguier M, Barrier A, Boelle PY, Houry S, Lacaine F (2006). "Ischemic colitis". Am. J. Surg. 192 (5): 679–84. doi:10.1016/j.amjsurg.2005.09.018. PMID 17071206.

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