Tropical sprue physical examination: Difference between revisions

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{{Tropical sprue}}
{{Tropical sprue}}
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==Overview==
==Overview==
There are no diagnostic physical signs in patients with TS. Although, in one extreme is the emaciated patient with progression to develop nutritional deficiencies resulting in signs os anemia, glossitis, stomatitis, dermatosis, peripheral edema, depigmentation of hair, xerosis conjunctivae. On the other extreme is a patient with no abnormal physical finings on examination, with the majority of patients falling in between these two extremes.
The physical examination findings in acute phase can be significant for [[dehydration]]. In the chronic phase, features of sub acute combined degeneration and [[Visual field defect|visual field defects]] are present.


==Physical Examination==
==Physical Examination==
===Appearance of the patient===
Physical examination findings in [[tropical sprue]] include:
===Vital signs===
 
===Skin===
===General Examination===
Signs of [[dehydration]] may be present on examination in patients in the acute phase, which include:<ref name="pmid7117904">{{cite journal| author=Ramakrishna BS, Mathan VI| title=Water and electrolyte absorption by the colon in tropical sprue. | journal=Gut | year= 1982 | volume= 23 | issue= 10 | pages= 843-6 | pmid=7117904 | doi= | pmc=1419837 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7117904  }} </ref><ref name="BrownBettington2014">{{cite journal|last1=Brown|first1=Ian S.|last2=Bettington|first2=Andrew|last3=Bettington|first3=Mark|last4=Rosty|first4=Christophe|title=Tropical Sprue|journal=The American Journal of Surgical Pathology|volume=38|issue=5|year=2014|pages=666–672|issn=0147-5185|doi=10.1097/PAS.0000000000000153}}</ref><ref name="pmid24441659">{{cite journal| author=Brown IS, Bettington A, Bettington M, Rosty C| title=Tropical sprue: revisiting an underrecognized disease. | journal=Am J Surg Pathol | year= 2014 | volume= 38 | issue= 5 | pages= 666-72 | pmid=24441659 | doi=10.1097/PAS.0000000000000153 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24441659  }} </ref>
 
* Dry [[tongue]]
* Low [[blood pressure]]
* Reduced or no [[urine output]]
* Reduced skin turgor
 
===HEENT===
===HEENT===
===Neck===
*[[Pallor]]
===Lungs===
*Angular [[stomatitis]]
===Heart===
*[[Glossitis]]
*[[Mouth ulcers]]
===Extremities===
*Peripheral [[edema]]
 
===Abdomen===
===Abdomen===
* Abdominal swelling due to distended intestine with clearly evident peristaltic waves may sometimes be seen.
*Abdominal examination is normal with no tenderness and [[organomegaly]]
* Loud, prolonged and disordered borborgymi, has to be differentiated from that of intestinal obstruction.
===CNS===
* When there is severe anemia, hypoproteinemia, or both, ascites and mild hepatosplenomegaly may be present.
In cases with severe [[vitamin B12 deficiency]] features of sub-acute degeneration of [[spinal cord]] can be demonstrated.
 
*[[Paresthesia]]s, lower extremities weakness, [[spasticity]], [[ataxic gait]]
===Back===
*Loss of [[vibration]] and position sense
===Genitourinary===
===Extremities===
===Neuromuscular===


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]
[[Category:Gastroenterology]]


{{WS}}
{{WS}}
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[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]

Latest revision as of 00:30, 30 July 2020

Tropical sprue Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

The physical examination findings in acute phase can be significant for dehydration. In the chronic phase, features of sub acute combined degeneration and visual field defects are present.

Physical Examination

Physical examination findings in tropical sprue include:

General Examination

Signs of dehydration may be present on examination in patients in the acute phase, which include:[1][2][3]

HEENT

Extremities

Abdomen

  • Abdominal examination is normal with no tenderness and organomegaly

CNS

In cases with severe vitamin B12 deficiency features of sub-acute degeneration of spinal cord can be demonstrated.

References

  1. Ramakrishna BS, Mathan VI (1982). "Water and electrolyte absorption by the colon in tropical sprue". Gut. 23 (10): 843–6. PMC 1419837. PMID 7117904.
  2. Brown, Ian S.; Bettington, Andrew; Bettington, Mark; Rosty, Christophe (2014). "Tropical Sprue". The American Journal of Surgical Pathology. 38 (5): 666–672. doi:10.1097/PAS.0000000000000153. ISSN 0147-5185.
  3. Brown IS, Bettington A, Bettington M, Rosty C (2014). "Tropical sprue: revisiting an underrecognized disease". Am J Surg Pathol. 38 (5): 666–72. doi:10.1097/PAS.0000000000000153. PMID 24441659.

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