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| __NOTOC__ | | __NOTOC__ |
| | | {{Infobox_Disease | |
| | Name = Hepatomegaly | |
| | Image = Hepatomegaly.jpg | |
| | }} |
| '''For patient information on this topic, click [[Hepatomegaly (patient information)|here]].''' | | '''For patient information on this topic, click [[Hepatomegaly (patient information)|here]].''' |
| {{Hepatomegaly}} | | {{Hepatomegaly}} |
| {{CMG}}; '''Associate Editor-In-Chief:''' {{IQ}} {{CZ}} | | {{CMG}}; '''Associate Editor-In-Chief:''' {{SMP}},{{IQ}}<br> |
| | |
| {{SK}} Enlarged liver; liver enlargement | | {{SK}} Enlarged liver; liver enlargement |
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| == Overview == | | == Overview == |
| The '''liver''' is an [[Organ (anatomy)|organ]] present in [[Vertebrate|vertebrates]] and some other animals. The adult human liver normally weighs between 1.4 - 1.6 kilograms (3.1 - 3.5 pounds), and it is a soft, pinkish-brown "boomerang shaped" organ. It is located on the right side of the upper [[Human abdomen|abdomen]] below the [[Diaphragm (anatomy)|diaphragm]]. The liver size increases with age and it ranges between 5 cm to 15 cm in adulthood. A normal liver is less than 16 cm in ultrasound evaluation. Hepatomegaly may be found in physical examination or during imaging studies. Imaging is more accurate in determining liver size.<ref name="pmid475535">{{cite journal| author=Sapira JD, Williamson DL| title=How big is the normal liver? | journal=Arch Intern Med | year= 1979 | volume= 139 | issue= 9 | pages= 971-3 | pmid=475535 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=475535 }} </ref><ref name="pmid6622701">{{cite journal| author=Niederau C, Sonnenberg A, Müller JE, Erckenbrecht JF, Scholten T, Fritsch WP| title=Sonographic measurements of the normal liver, spleen, pancreas, and portal vein. | journal=Radiology | year= 1983 | volume= 149 | issue= 2 | pages= 537-40 | pmid=6622701 | doi=10.1148/radiology.149.2.6622701 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6622701 }} </ref> In some certain conditions normal liver may be palpated as enlarged liver including thin people, during deep [[Inhalation|inspiration]], right [[pleural effusion]], and when [[emphysema]] results in hyperinflation of the chest with diaphragmatic descent and downward displacement of the [[liver]]. Common pathologic causes that may result in hepatomegaly are [[hepatitis]], [[Storage Disease|storage disorders]], impaired venous outflow, infiltrative disorders, and [[biliary obstruction]]. | | The '''liver''' is an [[Organ (anatomy)|organ]] present in [[Vertebrate|vertebrates]] and some other animals. The adult human liver normally weighs between 1.4 to 1.6 kilograms (3.1 to 3.5 pounds), and it is a soft, pinkish-brown "boomerang shaped" organ. It is located on the right side of the upper [[Human abdomen|abdomen]] below the [[Diaphragm (anatomy)|diaphragm]]. The size of the liver increases with age and ranges between 5 cm to 15 cm in adulthood. A normal liver is less than 16 cm on ultrasound evaluation. Hepatomegaly may be found during physical examination or on imaging studies. Imaging is more accurate in determining liver size.<ref name="pmid475535">{{cite journal| author=Sapira JD, Williamson DL| title=How big is the normal liver? | journal=Arch Intern Med | year= 1979 | volume= 139 | issue= 9 | pages= 971-3 | pmid=475535 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=475535 }} </ref><ref name="pmid6622701">{{cite journal| author=Niederau C, Sonnenberg A, Müller JE, Erckenbrecht JF, Scholten T, Fritsch WP| title=Sonographic measurements of the normal liver, spleen, pancreas, and portal vein. | journal=Radiology | year= 1983 | volume= 149 | issue= 2 | pages= 537-40 | pmid=6622701 | doi=10.1148/radiology.149.2.6622701 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6622701 }} </ref> In some conditions normal liver may be palpated as enlarged liver including thin people, during deep [[Inhalation|inspiration]], right [[pleural effusion]], and [[emphysema]] resulting in hyperinflation of the chest with diaphragmatic descent and downward displacement of the [[liver]]. Common pathological causes that may result in hepatomegaly are [[hepatitis]], [[Storage Disease|storage disorders]], impaired venous outflow, infiltrative disorders, and [[biliary obstruction]]. |
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| == Causes == | | == Causes == |
| Hepatomegaly may be classified on the basis of etiology into hepatitis, storage disorders, impaired venous outflow, infiltrative and obstructive causes.<ref name="pmid10970452">{{cite journal |vauthors=Wolf AD, Lavine JE |title=Hepatomegaly in neonates and children |journal=Pediatr Rev |volume=21 |issue=9 |pages=303–10 |year=2000 |pmid=10970452 |doi= |url=}}</ref><ref name="pmid16454833">{{cite journal |vauthors=Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH |title=Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A |journal=Am. J. Gastroenterol. |volume=101 |issue=2 |pages=292–6 |year=2006 |pmid=16454833 |doi=10.1111/j.1572-0241.2006.00416.x |url=}}</ref><ref name="pmid23485521">{{cite journal |vauthors=Bernstein DL, Hülkova H, Bialer MG, Desnick RJ |title=Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease |journal=J. Hepatol. |volume=58 |issue=6 |pages=1230–43 |year=2013 |pmid=23485521 |doi=10.1016/j.jhep.2013.02.014 |url=}}</ref><ref name="pmid16625098">{{cite journal |vauthors=Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L |title=Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=508–13 |year=2006 |pmid=16625098 |doi= |url=}}</ref><ref name="pmid8982149">{{cite journal |vauthors=Chatila R, West AB |title=Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes |journal=Medicine (Baltimore) |volume=75 |issue=6 |pages=327–33 |year=1996 |pmid=8982149 |doi= |url=}}</ref><ref name="pmid28043933">{{cite journal |vauthors=Mukewar S, Sharma A, Lackore KA, Enders FT, Torbenson MS, Kamath PS, Roberts LR, Kudva YC |title=Clinical, Biochemical, and Histopathology Features of Patients With Glycogenic Hepatopathy |journal=Clin. Gastroenterol. Hepatol. |volume=15 |issue=6 |pages=927–933 |year=2017 |pmid=28043933 |doi=10.1016/j.cgh.2016.11.038 |url=}}</ref><ref name="pmid11025794">{{cite journal |vauthors=Charrow J, Andersson HC, Kaplan P, Kolodny EH, Mistry P, Pastores G, Rosenbloom BE, Scott CR, Wappner RS, Weinreb NJ, Zimran A |title=The Gaucher registry: demographics and disease characteristics of 1698 patients with Gaucher disease |journal=Arch. Intern. Med. |volume=160 |issue=18 |pages=2835–43 |year=2000 |pmid=11025794 |doi= |url=}}</ref><ref name="pmid18312287">{{cite journal |vauthors=Drebber U, Kasper HU, Ratering J, Wedemeyer I, Schirmacher P, Dienes HP, Odenthal M |title=Hepatic granulomas: histological and molecular pathological approach to differential diagnosis--a study of 442 cases |journal=Liver Int. |volume=28 |issue=6 |pages=828–34 |year=2008 |pmid=18312287 |doi=10.1111/j.1478-3231.2008.01695.x |url=}}</ref><ref name="pmid14530778">{{cite journal |vauthors=Park MA, Mueller PS, Kyle RA, Larson DR, Plevak MF, Gertz MA |title=Primary (AL) hepatic amyloidosis: clinical features and natural history in 98 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=291–8 |year=2003 |pmid=14530778 |doi=10.1097/01.md.0000091183.93122.c7 |url=}}</ref><ref name="pmid8943863">{{cite journal |vauthors=Cooke CB, Krenacs L, Stetler-Stevenson M, Greiner TC, Raffeld M, Kingma DW, Abruzzo L, Frantz C, Kaviani M, Jaffe ES |title=Hepatosplenic T-cell lymphoma: a distinct clinicopathologic entity of cytotoxic gamma delta T-cell origin |journal=Blood |volume=88 |issue=11 |pages=4265–74 |year=1996 |pmid=8943863 |doi= |url=}}</ref><ref name="pmid870368">{{cite journal |vauthors=Long RG, Scheuer PJ, Sherlock S |title=Presentation and course of asymptomatic primary biliary cirrhosis |journal=Gastroenterology |volume=72 |issue=6 |pages=1204–7 |year=1977 |pmid=870368 |doi= |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref>
| | Various causes of hepatomegaly may be classified on the basis of etiology into hepatitis, storage disorders, impaired venous outflow, infiltrative, and obstructive causes.<ref name="pmid10970452">{{cite journal |vauthors=Wolf AD, Lavine JE |title=Hepatomegaly in neonates and children |journal=Pediatr Rev |volume=21 |issue=9 |pages=303–10 |year=2000 |pmid=10970452 |doi= |url=}}</ref><ref name="pmid16454833">{{cite journal |vauthors=Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH |title=Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A |journal=Am. J. Gastroenterol. |volume=101 |issue=2 |pages=292–6 |year=2006 |pmid=16454833 |doi=10.1111/j.1572-0241.2006.00416.x |url=}}</ref><ref name="pmid23485521">{{cite journal |vauthors=Bernstein DL, Hülkova H, Bialer MG, Desnick RJ |title=Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease |journal=J. Hepatol. |volume=58 |issue=6 |pages=1230–43 |year=2013 |pmid=23485521 |doi=10.1016/j.jhep.2013.02.014 |url=}}</ref><ref name="pmid16625098">{{cite journal |vauthors=Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L |title=Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=508–13 |year=2006 |pmid=16625098 |doi= |url=}}</ref><ref name="pmid8982149">{{cite journal |vauthors=Chatila R, West AB |title=Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes |journal=Medicine (Baltimore) |volume=75 |issue=6 |pages=327–33 |year=1996 |pmid=8982149 |doi= |url=}}</ref><ref name="pmid28043933">{{cite journal |vauthors=Mukewar S, Sharma A, Lackore KA, Enders FT, Torbenson MS, Kamath PS, Roberts LR, Kudva YC |title=Clinical, Biochemical, and Histopathology Features of Patients With Glycogenic Hepatopathy |journal=Clin. Gastroenterol. Hepatol. |volume=15 |issue=6 |pages=927–933 |year=2017 |pmid=28043933 |doi=10.1016/j.cgh.2016.11.038 |url=}}</ref><ref name="pmid11025794">{{cite journal |vauthors=Charrow J, Andersson HC, Kaplan P, Kolodny EH, Mistry P, Pastores G, Rosenbloom BE, Scott CR, Wappner RS, Weinreb NJ, Zimran A |title=The Gaucher registry: demographics and disease characteristics of 1698 patients with Gaucher disease |journal=Arch. Intern. Med. |volume=160 |issue=18 |pages=2835–43 |year=2000 |pmid=11025794 |doi= |url=}}</ref><ref name="pmid18312287">{{cite journal |vauthors=Drebber U, Kasper HU, Ratering J, Wedemeyer I, Schirmacher P, Dienes HP, Odenthal M |title=Hepatic granulomas: histological and molecular pathological approach to differential diagnosis--a study of 442 cases |journal=Liver Int. |volume=28 |issue=6 |pages=828–34 |year=2008 |pmid=18312287 |doi=10.1111/j.1478-3231.2008.01695.x |url=}}</ref><ref name="pmid14530778">{{cite journal |vauthors=Park MA, Mueller PS, Kyle RA, Larson DR, Plevak MF, Gertz MA |title=Primary (AL) hepatic amyloidosis: clinical features and natural history in 98 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=291–8 |year=2003 |pmid=14530778 |doi=10.1097/01.md.0000091183.93122.c7 |url=}}</ref><ref name="pmid8943863">{{cite journal |vauthors=Cooke CB, Krenacs L, Stetler-Stevenson M, Greiner TC, Raffeld M, Kingma DW, Abruzzo L, Frantz C, Kaviani M, Jaffe ES |title=Hepatosplenic T-cell lymphoma: a distinct clinicopathologic entity of cytotoxic gamma delta T-cell origin |journal=Blood |volume=88 |issue=11 |pages=4265–74 |year=1996 |pmid=8943863 |doi= |url=}}</ref><ref name="pmid870368">{{cite journal |vauthors=Long RG, Scheuer PJ, Sherlock S |title=Presentation and course of asymptomatic primary biliary cirrhosis |journal=Gastroenterology |volume=72 |issue=6 |pages=1204–7 |year=1977 |pmid=870368 |doi= |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref> |
| {| class="wikitable" | | {| class="wikitable" |
| !Etiology | | !Etiology |
| Line 17: |
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| !Disease | | !Disease |
| |- | | |- |
| | rowspan="11" |Hepatitis | | | rowspan="11" |[[Hepatitis]] |
| | rowspan="4" |Infections | | | rowspan="4" |Infections |
| |Acute and chronic viral hepatitis | | |Acute and chronic [[hepatitis|viral hepatitis]] |
| |- | | |- |
| |Bacterial liver abscess | | |Bacterial [[liver abscess]] |
| |- | | |- |
| |Parasitic infections | | |[[Parasitic infections]] |
| |- | | |- |
| |Granulomatous hepatitis | | |[[Granulomatous hepatitis]] |
| |- | | |- |
| |Ischemia | | |[[Ischemia]] |
| |Ischemic hepatitis ("shock liver") | | |[[Ischemic hepatitis]] ("[[shock liver]]") |
| |- | | |- |
| |Toxins | | |Toxins |
| |Alcoholic hepatitis | | |[[Alcoholic hepatitis]] |
| |- | | |- |
| | rowspan="2" |Steatosis | | | rowspan="2" |[[Steatosis]] |
| |Alcoholic fatty liver disease | | |[[Alcoholic liver disease|Alcoholic fatty liver disease]] |
| |- | | |- |
| |Nonalcoholic steatohepatitis | | |Nonalcoholic [[Fatty liver|steatohepatitis]] |
| |- | | |- |
| |Drugs/Medications | | |[[Medication|Medications]] |
| |Drug induced liver injury (DILI) | | |[[Drug induced liver injury]] (DILI) |
| |- | | |- |
| |Immune mediated hepatitis | | |Immune mediated [[hepatitis]] |
| |Autoimmune hepatitis | | |[[Autoimmune hepatitis]] |
| |- | | |- |
| |Copper deposition | | |Copper deposition |
| |Wilson disease | | |[[Wilson's disease|Wilson disease]] |
| |- | | |- |
| | rowspan="6" |Storage disorders | | | rowspan="6" |Storage disorders |
| | rowspan="2" |Glycogen | | | rowspan="2" |Glycogen |
| |Glycogen storage disorders | | |[[Glycogen storage disease|Glycogen storage disorders]] |
| |- | | |- |
| |Diabetes mellitus | | |[[Diabetes mellitus]] |
| |- | | |- |
| | rowspan="2" |Lipid | | | rowspan="2" |Lipid |
| |Gaucher disease | | |[[Gaucher's disease|Gaucher disease]] |
| |- | | |- |
| |Nonalcoholic steatohepatitis | | |[[Nonalcoholic steatohepatitis]] |
| |- | | |- |
| |Protein | | |Protein |
| |Alpha-1 antitrypsin deficiency | | |[[Alpha 1-antitrypsin deficiency|Alpha-1 antitrypsin deficiency]] |
| |- | | |- |
| |Iron | | |Iron |
| |Hemochromatosis | | |[[Hemochromatosis]] |
| |- | | |- |
| | rowspan="6" |Impaired venous outflow | | | rowspan="6" |Impaired venous outflow |
| | rowspan="2" |Cardiac | | | rowspan="2" |Cardiac |
| |Right heart failure | | |[[Right heart failure]] |
| |- | | |- |
| |Constrictive pericarditis | | |[[Constrictive pericarditis]] |
| |- | | |- |
| | rowspan="2" |Hepatic vein | | | rowspan="2" |Hepatic vein |
| |Hepatic vein thrombosis | | |[[Budd-Chiari syndrome|Hepatic vein thrombosis]] |
| |- | | |- |
| |Inferior vena cava web | | |[[Inferior vena cava]] web |
| |- | | |- |
| | rowspan="2" |Intrahepatic | | | rowspan="2" |Intrahepatic |
| |Sinusoidal obstruction syndrome | | |[[Sinusoidal obstruction syndrome]] |
| |- | | |- |
| |Peliosis hepatis | | |[[Peliosis hepatis]] |
| |- | | |- |
| | rowspan="11" |Infiltrative diseases | | | rowspan="11" |Infiltrative diseases |
| | rowspan="3" |Benign primary liver tumors | | | rowspan="3" |Benign primary liver tumors |
| |Hemangiomas | | |[[Diffuse neonatal hemangiomatosis|Hemangiomas]] |
| |- | | |- |
| |Adenomas | | |[[Adenoma|Adenomas]] |
| |- | | |- |
| |Focal nodular hyperplasia | | |[[Focal nodular hyperplasia]] |
| |- | | |- |
| | rowspan="4" |Malignant primary liver tumors | | | rowspan="4" |Malignant primary liver tumors |
| |Hepatocellular carcinoma | | |[[Hepatocellular carcinoma]] |
| |- | | |- |
| |Cholangiocarcinoma | | |[[Cholangiocarcinoma]] |
| |- | | |- |
| |Fibrolamellar carcinoma | | |Fibrolamellar carcinoma |
| |- | | |- |
| |Hemangioendothelioma | | |[[Hemangioendothelioma]] |
| |- | | |- |
| | rowspan="4" |Metastatic/disseminated tumors | | | rowspan="4" |Metastatic or disseminated tumors |
| |Myeloma | | |[[Multiple myeloma|Myeloma]] |
| |- | | |- |
| |Lymphoma | | |[[Lymphoma]] |
| |- | | |- |
| |Leukemia | | |[[Leukemia]] |
| |- | | |- |
| |Metastatic solid tumors | | |[[Metastatic solid tumors]] |
| |- | | |- |
| | rowspan="3" |Biliary obstruction | | | rowspan="3" |Biliary obstruction |
| | colspan="2" |Primary biliary cirrhosis | | | colspan="2" |[[Primary biliary cirrhosis]] |
| |- | | |- |
| | colspan="2" |Primary sclerosing cholangitis | | | colspan="2" |[[Primary sclerosing cholangitis]] |
| |- | | |- |
| | colspan="2" |Biliary atresia | | | colspan="2" |[[Biliary atresia]] |
| |- | | |- |
| | rowspan="3" |Other | | | rowspan="3" |Other |
| |Anatomic variations | | |Anatomic variations |
| |Riedel's lobe | | |[[Riedel's lobe]] |
| |- | | |- |
| | rowspan="2" |Cystic liver disease | | | rowspan="2" |Cystic liver disease |
| |Polycystic liver disease | | |[[Polycystic liver disease]] |
| |- | | |- |
| |Caroli's disease | | |[[Caroli's disease]] |
| |} | | |} |
|
| |
|
| == Differential diagnosis == | | == Differential Diagnosis == |
| Patients with hepatomegaly need to be differentiated from other patients presenting with similar complaints such as abdominal pain.<ref name="pmid10970452">{{cite journal |vauthors=Wolf AD, Lavine JE |title=Hepatomegaly in neonates and children |journal=Pediatr Rev |volume=21 |issue=9 |pages=303–10 |year=2000 |pmid=10970452 |doi= |url=}}</ref><ref name="pmid16454833">{{cite journal |vauthors=Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH |title=Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A |journal=Am. J. Gastroenterol. |volume=101 |issue=2 |pages=292–6 |year=2006 |pmid=16454833 |doi=10.1111/j.1572-0241.2006.00416.x |url=}}</ref><ref name="pmid23485521">{{cite journal |vauthors=Bernstein DL, Hülkova H, Bialer MG, Desnick RJ |title=Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease |journal=J. Hepatol. |volume=58 |issue=6 |pages=1230–43 |year=2013 |pmid=23485521 |doi=10.1016/j.jhep.2013.02.014 |url=}}</ref><ref name="pmid16625098">{{cite journal |vauthors=Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L |title=Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=508–13 |year=2006 |pmid=16625098 |doi= |url=}}</ref><ref name="pmid8982149">{{cite journal |vauthors=Chatila R, West AB |title=Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes |journal=Medicine (Baltimore) |volume=75 |issue=6 |pages=327–33 |year=1996 |pmid=8982149 |doi= |url=}}</ref><ref name="pmid28043933">{{cite journal |vauthors=Mukewar S, Sharma A, Lackore KA, Enders FT, Torbenson MS, Kamath PS, Roberts LR, Kudva YC |title=Clinical, Biochemical, and Histopathology Features of Patients With Glycogenic Hepatopathy |journal=Clin. Gastroenterol. Hepatol. |volume=15 |issue=6 |pages=927–933 |year=2017 |pmid=28043933 |doi=10.1016/j.cgh.2016.11.038 |url=}}</ref><ref name="pmid11025794">{{cite journal |vauthors=Charrow J, Andersson HC, Kaplan P, Kolodny EH, Mistry P, Pastores G, Rosenbloom BE, Scott CR, Wappner RS, Weinreb NJ, Zimran A |title=The Gaucher registry: demographics and disease characteristics of 1698 patients with Gaucher disease |journal=Arch. Intern. Med. |volume=160 |issue=18 |pages=2835–43 |year=2000 |pmid=11025794 |doi= |url=}}</ref><ref name="pmid18312287">{{cite journal |vauthors=Drebber U, Kasper HU, Ratering J, Wedemeyer I, Schirmacher P, Dienes HP, Odenthal M |title=Hepatic granulomas: histological and molecular pathological approach to differential diagnosis--a study of 442 cases |journal=Liver Int. |volume=28 |issue=6 |pages=828–34 |year=2008 |pmid=18312287 |doi=10.1111/j.1478-3231.2008.01695.x |url=}}</ref><ref name="pmid14530778">{{cite journal |vauthors=Park MA, Mueller PS, Kyle RA, Larson DR, Plevak MF, Gertz MA |title=Primary (AL) hepatic amyloidosis: clinical features and natural history in 98 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=291–8 |year=2003 |pmid=14530778 |doi=10.1097/01.md.0000091183.93122.c7 |url=}}</ref><ref name="pmid8943863">{{cite journal |vauthors=Cooke CB, Krenacs L, Stetler-Stevenson M, Greiner TC, Raffeld M, Kingma DW, Abruzzo L, Frantz C, Kaviani M, Jaffe ES |title=Hepatosplenic T-cell lymphoma: a distinct clinicopathologic entity of cytotoxic gamma delta T-cell origin |journal=Blood |volume=88 |issue=11 |pages=4265–74 |year=1996 |pmid=8943863 |doi= |url=}}</ref><ref name="pmid870368">{{cite journal |vauthors=Long RG, Scheuer PJ, Sherlock S |title=Presentation and course of asymptomatic primary biliary cirrhosis |journal=Gastroenterology |volume=72 |issue=6 |pages=1204–7 |year=1977 |pmid=870368 |doi= |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref> | | Patients with hepatomegaly need to be differentiated from other patients presenting with similar complaints such as abdominal pain.<ref name="pmid10970452">{{cite journal |vauthors=Wolf AD, Lavine JE |title=Hepatomegaly in neonates and children |journal=Pediatr Rev |volume=21 |issue=9 |pages=303–10 |year=2000 |pmid=10970452 |doi= |url=}}</ref><ref name="pmid16454833">{{cite journal |vauthors=Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH |title=Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A |journal=Am. J. Gastroenterol. |volume=101 |issue=2 |pages=292–6 |year=2006 |pmid=16454833 |doi=10.1111/j.1572-0241.2006.00416.x |url=}}</ref><ref name="pmid23485521">{{cite journal |vauthors=Bernstein DL, Hülkova H, Bialer MG, Desnick RJ |title=Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease |journal=J. Hepatol. |volume=58 |issue=6 |pages=1230–43 |year=2013 |pmid=23485521 |doi=10.1016/j.jhep.2013.02.014 |url=}}</ref><ref name="pmid16625098">{{cite journal |vauthors=Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L |title=Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=508–13 |year=2006 |pmid=16625098 |doi= |url=}}</ref><ref name="pmid8982149">{{cite journal |vauthors=Chatila R, West AB |title=Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes |journal=Medicine (Baltimore) |volume=75 |issue=6 |pages=327–33 |year=1996 |pmid=8982149 |doi= |url=}}</ref><ref name="pmid28043933">{{cite journal |vauthors=Mukewar S, Sharma A, Lackore KA, Enders FT, Torbenson MS, Kamath PS, Roberts LR, Kudva YC |title=Clinical, Biochemical, and Histopathology Features of Patients With Glycogenic Hepatopathy |journal=Clin. Gastroenterol. Hepatol. |volume=15 |issue=6 |pages=927–933 |year=2017 |pmid=28043933 |doi=10.1016/j.cgh.2016.11.038 |url=}}</ref><ref name="pmid11025794">{{cite journal |vauthors=Charrow J, Andersson HC, Kaplan P, Kolodny EH, Mistry P, Pastores G, Rosenbloom BE, Scott CR, Wappner RS, Weinreb NJ, Zimran A |title=The Gaucher registry: demographics and disease characteristics of 1698 patients with Gaucher disease |journal=Arch. Intern. Med. |volume=160 |issue=18 |pages=2835–43 |year=2000 |pmid=11025794 |doi= |url=}}</ref><ref name="pmid18312287">{{cite journal |vauthors=Drebber U, Kasper HU, Ratering J, Wedemeyer I, Schirmacher P, Dienes HP, Odenthal M |title=Hepatic granulomas: histological and molecular pathological approach to differential diagnosis--a study of 442 cases |journal=Liver Int. |volume=28 |issue=6 |pages=828–34 |year=2008 |pmid=18312287 |doi=10.1111/j.1478-3231.2008.01695.x |url=}}</ref><ref name="pmid14530778">{{cite journal |vauthors=Park MA, Mueller PS, Kyle RA, Larson DR, Plevak MF, Gertz MA |title=Primary (AL) hepatic amyloidosis: clinical features and natural history in 98 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=291–8 |year=2003 |pmid=14530778 |doi=10.1097/01.md.0000091183.93122.c7 |url=}}</ref><ref name="pmid8943863">{{cite journal |vauthors=Cooke CB, Krenacs L, Stetler-Stevenson M, Greiner TC, Raffeld M, Kingma DW, Abruzzo L, Frantz C, Kaviani M, Jaffe ES |title=Hepatosplenic T-cell lymphoma: a distinct clinicopathologic entity of cytotoxic gamma delta T-cell origin |journal=Blood |volume=88 |issue=11 |pages=4265–74 |year=1996 |pmid=8943863 |doi= |url=}}</ref><ref name="pmid870368">{{cite journal |vauthors=Long RG, Scheuer PJ, Sherlock S |title=Presentation and course of asymptomatic primary biliary cirrhosis |journal=Gastroenterology |volume=72 |issue=6 |pages=1204–7 |year=1977 |pmid=870368 |doi= |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref> |
|
| |
|
| <span style="font-size:85%">'''Abbreviations:''' | | <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]], US = [[Ultrasound]]</span> | | '''[[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]], US = [[Ultrasound]]</span> |
| <small><small>
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| {| align="center"
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| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" |
| ! colspan="3" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Classification of pain in the abdomen based on etiology | | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Organ system |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease |
| | colspan="13" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations''' | | | colspan="7" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations''' |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis | | ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments | | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| |- | | |- |
| | colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms''' | | | colspan="5" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms''' |
| ! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs | | ! colspan="2" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever | | ! 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" |Nausea or vomiting |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice | | ! 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" |Weight loss |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- |
| tension | | 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" |Rebound Tenderness |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings | | ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging |
| |- | | |- |
| ! rowspan="55" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal causes | | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Pancreato-biliary disorders |
| ! rowspan="40" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Inflammatory causes
| |
| ! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pancreato-biliary disorders
| |
| | 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: #DCDCDC;" align="center" |[[Pancreatic carcinoma]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] | | | 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" |<nowiki>+</nowiki> | | | 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" |<nowiki>+</nowiki> | | | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * ↑ [[Alkaline phosphatase]] | | * ↑ [[Alkaline phosphatase]] |
| Line 304: |
Line 175: |
| * [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]]) | | * [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]]) |
| * [[Panniculitis|Pancreatic panniculitis]] | | * [[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]] | | | 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" |[[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="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" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Increased AMA level, abnormal [[LFTs]] | | * Increased [[AMA]] level |
| | * Abnormal [[LFTs]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * ERCP | | * ERCP |
| Line 348: |
Line 195: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | | | 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="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" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Increased liver enzymes | | * Increased liver enzymes |
| Line 366: |
Line 207: |
| * [[Anti-smooth muscle antibody]] (Anti-Sm) | | * [[Anti-smooth muscle antibody]] (Anti-Sm) |
| * Anti-endothelial antibody | | * Anti-endothelial antibody |
| * Anti-cardiolipin antibody | | * [[Anti-cardiolipin antibodies|Anti-cardiolipin antibody]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |ERCP and MRCP shows | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |ERCP and MRCP shows |
| * Multiple segmental [[strictures]] | | * Multiple segmental [[strictures]] |
| Line 375: |
Line 216: |
| * The risk of [[cholangiocarcinoma]] in patients with primary sclerosing cholangitis is 400 times higher than the risk in the general population. | | * 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]] | | | rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Systemic disease''' |
| | 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
| |
| |-
| |
| ! colspan="1" rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Gastric causes
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Peptic Ulcer Disease|Peptic ulcer 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" | <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" |
| |
| * Gastric ulcer- [[melena]] and [[hematemesis]]
| |
| * Duodenal ulcer- [[melena]] and [[hematochezia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ascitic fluid
| |
| ** [[LDH]] > serum [[LDH]]
| |
| ** Glucose < 50mg/dl
| |
| ** Total protein > 1g/dl
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Air under [[diaphragm]] in upright [[CXR]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Upper GI [[endoscopy]] for diagnosis
| |
| |-
| |
| ! 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" |[[Gastritis|Gastritis]]
| |
| | 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" | Positive in chronic gastritis
| |
| | 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" |
| |
| * [[H.pylori infection diagnostic tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Endoscopy]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[H.pylori gastritis guideline recommendation]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastroesophageal reflux disease|Gastroesophageal reflux disease]]
| |
| | 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" | −
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Gastric emptying studies
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Esophageal]] [[manometry]]
| |
| * [[Endoscopy]] for alarm signs
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastric outlet obstruction|Gastric outlet obstruction]]
| |
| | 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" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Complete blood count]]
| |
| * [[Basic metabolic panel]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Abdominal x-ray]]- air fluid level
| |
| * Barium [[Upper GI series|upper GI studies]]- narrowed pylorus
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Succussion splash
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastroparesis]]
| |
| | 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" |Hyperactive/hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Hemoglobin]]
| |
| *Fasting plasma glucose
| |
| *Serum total protein, albumin, [[thyrotropin]] ([[Thyroid-stimulating hormone|TSH]]), and an [[antinuclear antibody]] (ANA) titer
| |
| *[[HbA1c]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *Scintigraphic gastric emptying
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *Succussion splash
| |
| *Single photon emission computed tomography (SPECT)
| |
| *Full thickness gastric and small intestinal biopsy
| |
| |-
| |
| | 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" |[[Dumping syndrome]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Lower and then 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" |<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" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Glucose challenge test
| |
| * [[Hydrogen Breath Test|Hydrogen breath test]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Upper gastrointestinal series|Upper GI series]]
| |
| * Gastric emptying study
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Postgastrectomy
| |
| |-
| |
| ! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Intestinal causes
| |
| ! 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" |[[Acute appendicitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Starts in [[epigastrium]], migrates to RLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in pyogenic appendicitis
| |
| | 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" | Positive in perforated appendicitis
| |
| | 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" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ct scan
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Positive Rovsing sign
| |
| * Positive Obturator sign
| |
| * Positive Iliopsoas sign
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diverticulitis|Acute diverticulitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |LLQ
| |
| | 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" |<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" | Positive in perforated diverticulitis
| |
| | 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" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CT scan
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * History of [[constipation]]
| |
| |-
| |
| | 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" |[[Irritable bowel syndrome]]
| |
| | 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" |Normal
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Symptomatic treatment
| |
| * High [[dietary fiber]]
| |
| | |
| * [[Osmotic]] [[laxatives]]
| |
| * [[Antispasmodic]] drugs
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Whipple's disease]] | | | 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" |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" | ± |
| | 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" |<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="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Thrombocytopenia]] | | * [[Thrombocytopenia]] |
| Line 722: |
Line 244: |
| * [[Ascites]] | | * [[Ascites]] |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hemochromatosis]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |− |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| | * >60% TS |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| | * >240 μg/L SF |
| tension
| | * Raised LFT |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| | * Hyperglycemia |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| | * Ultrasound shows evidence of cirrhosis |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Extra intestinal findings: |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| | * Hyperpigmentation |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| | * Diabetes mellitus |
| | * Arthralgia |
| | * Impotence in males |
| | * Cardiomyopathy |
| | * Atherosclerosis |
| | * Hypopituitarism |
| | * Hypothyroidism |
| | * Extrahepatic cancer |
| | * Prone to specific infections |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic megacolon]] | | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Hematologic causes |
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Myeloma |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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="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" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Anemia]] | | * [[Anemia]] |
| *[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]] | | * Elevated ESR and CRP |
| *[[Hypoalbuminemia]]
| | * Proteinuria |
| *[[Metabolic alkalosis]] associated with a poor [[prognosis]]
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |− |
| *[[Metabolic acidosis]] secondary to [[ischemic colitis]] | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT and [[Ultrasound]] shows: | |
| *Loss of colonic haustration
| |
| *Hypoechoic and thickened bowel walls with irregular internal margins in the [[sigmoid]] and descending colon
| |
| *Prominent dilation of the transverse colon (>6 cm)
| |
| | |
| * Insignificant dilation of ileal bowel loops (diameter >18 mm) with increased intraluminal gas and fluid
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | * Mainly in old age |
| | * Back pain |
| | * Kidney involvement |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tropical sprue]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Lymphoma |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" |<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="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Fat soluble vitamin deficiency
| |
| * [[Hypoalbuminemia]]
| |
| * Fecal stool test
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Barium studies:
| |
| * Dilation and edema of mucosal folds
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Steatorrhea]]- 10-40 g/day (Normal=5 g/day)
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Celiac 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" |<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="left" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[IgA]] endomysial antibody | | * Anemia |
| * [[IgA]] [[tissue transglutaminase]] antibody | | * Elevated ESR and CRP |
| * [[Anti-gliadin antibodies|Anti-gliadin antibody]]
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |− |
| * Small bowel biopsy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |US: | |
| * Bull’s eye or target pattern
| |
| * Pseudokidney sign
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Gluten allergy
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infective colitis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Leukemia |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" |<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="center" | Positive in fulminant colitis
| |
| | 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
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Stool culture]] and studies | | * Anemia |
| * Shiga toxin in bloody diarrhea | | * Elevated ESR and CRP |
| * [[PCR]]
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |− |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan | |
| * Bowel wall thickening
| |
| * Edema
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |- | | |- |
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" | |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever | | ! 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" |Nausea or vomiting |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice | | ! 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" |Weight loss |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- |
| tension | | 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" |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" |Lab Findings |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Colon carcinoma]] | | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Cardiac causes |
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Heart failure |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse/ RLQ/LLQ | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse/ RLQ/LLQ |
| | 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" |<nowiki>+</nowiki> | | | 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="left" |
| |
| * Normal or hyperactive if obstruction present
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * CBC | | * CBC |
| * Carcinoembryonic antigen (CEA) | | * Increased BNP and Pro BNP |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Colonoscopy | | * Echocardiography |
| * Flexible sigmoidoscopy
| |
| * Barium enema
| |
| * CT colonography
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction | | * Exertional dyspnea |
| | * Chest pain |
| | * Edema |
| | |- |
| | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Constrictive pericarditis |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse/ RLQ/LLQ |
| | | 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" | |
| | * Echocardiography |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | |
| | * Exertional dyspnea |
| | * Chest pain |
| | * Edema |
| |- | | |- |
| ! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatic causes | | ! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Hepatic causes |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|Viral hepatitis]] | | | 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" |[[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" |<nowiki>+</nowiki> | | | 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" | Positive in Hep A and E
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | | | 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 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="center" | + |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Abnormal LFTs | | * Abnormal LFTs |
| Line 911: |
Line 387: |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]] | | | 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" |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" |<nowiki>+</nowiki> | | | 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" |<nowiki>+</nowiki> | | | 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="left" |Normal or hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * CBC | | * CBC |
| Line 935: |
Line 405: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ | | | 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" |<nowiki>+</nowiki> | | | 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="left" |
| |
| * Normal
| |
| * Hyperactive if obstruction present
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * High levels of [[Alpha-fetoprotein|AFP]] in serum | | * High levels of [[Alpha-fetoprotein|AFP]] in serum |
| Line 962: |
Line 424: |
| * [[Spider nevi]] | | * [[Spider nevi]] |
| * [[Asterixis]] | | * [[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: #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" |[[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" | ± |
| Line 991: |
Line 433: |
| | 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" | | | | 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 [[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]]. | | *Elevated serum [[alkaline phosphatase]] and [[Bilirubin|bilirubin levels]], decreased [[Albumin|serum albumin level]]. |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan findings: |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| | * Early enhancement of the [[caudate lobe]] and [[central liver]] around the [[Inferior vena cavae|inferior vena cava]] |
| |-
| |
| | 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) | | *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: | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Ascitic tap|Ascitic fluid examination]] shows: |
| *[[Total protein]] more than 2.5 g per deciliter | | *[[Total protein]] more than 2.5 g per deciliter |
| *[[White blood cells]] are usually less than 500/μL. | | *[[White blood cells]] are usually less than 500/μL. |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hemochromatosis]]
| |
| | 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 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="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * >60% TS
| |
| * >240 μg/L SF
| |
| * Raised LFT <br>Hyperglycemia
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows evidence of cirrhosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
| |
| * Hyperpigmentation
| |
| * Diabetes mellitus
| |
| * Arthralgia
| |
| * Impotence in males
| |
| * Cardiomyopathy
| |
| * Atherosclerosis
| |
| * Hypopituitarism
| |
| * Hypothyroidism
| |
| * Extrahepatic cancer
| |
| * Prone to specific infections
| |
| |-
| |
| | 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
| |
| |-
| |
| ! 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
| |
| |-
| |
| ! rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Peritoneal causes
| |
| | 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" |
| |
| |-
| |
| ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Renal causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pyelonephritis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Unilateral
| |
| | 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" |
| |
| * Urinalysis
| |
| * Urine culture
| |
| * Blood culture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CT
| |
| * MRI
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *CVA tenderness
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Renal colic]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Flank pain]]
| |
| | 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" |
| |
| * [[Hematuria]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| * CT scan
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Colicky [[abdominal pain]]
| |
| * [[Dysuria]]
| |
| |-
| |
| ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Hollow Viscous Obstruction
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Small bowel obstruction]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |Hyperactive then absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]] with left shift indicates complications
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal X-ray|Abdominal X ray]]
| |
| * Dilated loops of bowel with air fluid levels
| |
| * Gasless abdomen
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * "Target sign"– , indicative of intussusception
| |
| * Venous cut-off sign" – suggests thrombosis
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Volvulus]]
| |
| | 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" |<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" | Positive in perforated cases
| |
| | 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="left" |Hyperactive then absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan and [[Abdominal x-ray|abdominal X ray]]
| |
| * U shaped sigmoid colon
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * "Whirl sign"
| |
| |-
| |
| | 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" |
| |
| |-
| |
| ! 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
| |
| |-
| |
| ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Vascular Disorders
| |
| ! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Ischemic causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mesenteric ischemia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Periumbilical
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive if bowel becomes gangrenous
| |
| | 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" | Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive to absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]] and [[lactic acidosis]]
| |
| * [[Amylase]] levels
| |
| * [[D-dimer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT angiography
| |
| * SMA or SMV thrombosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Also known as abdominal angina that worsens with eating
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ischemic colitis|Acute ischemic colitis]]
| |
| | 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" |<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" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive then absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal x-ray]]
| |
| * Distension and pneumatosis
| |
| CT scan
| |
| * Double halo appearance, thumbprinting
| |
| * Thickening of bowel
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * May lead to shock
| |
| |-
| |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hemorrhagic causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ruptured abdominal aortic aneurysm]]
| |
| | 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" |<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" |
| |
| * [[Fibrinogen]]
| |
| * [[D-dimer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Focused Assessment with Sonography in Trauma (FAST)
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Unstable hemodynamics
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Intra-abdominal or [[retroperitoneal hemorrhage]]
| |
| | 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" | −
| |
| | 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" |
| |
| * ↓ Hb
| |
| * ↓ Hct
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CT scan
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * History of [[trauma]]
| |
| |-
| |
| ! 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
| |
| |-
| |
| ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Gynaecological Causes
| |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Tubal causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Torsion of the cyst/ovary
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | 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" |
| |
| * ↑ [[ESR]]
| |
| * ↑ [[CRP]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Sudden onset & severe pain
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Salpingitis|Acute salpingitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | 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" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Pelvic ultrasound]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Vaginal discharge]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cyst rupture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | 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" |
| |
| * ↑ [[ESR]]
| |
| * ↑ [[CRP]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pregnancy
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Ruptured [[ectopic pregnancy]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | 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" |
| |
| * Positive [[pregnancy test]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of
| |
| * Missed period
| |
| * Vaginal bleeding
| |
| |-
| |
| ! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra-abdominal causes
| |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pulmonary disorders
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pleural empyema]]
| |
| | 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" |<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" |
| |
| * [[Thoracentesis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Chest X-ray]]
| |
| * Pleural opacity
| |
|
| |
| * Localization of effusion
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Physical examination
| |
| * Crackles
| |
| * [[Egophony]]
| |
| * Increased [[tactile fremitus]]
| |
| |-
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary embolism]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ/LUQ
| |
| | 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" |
| |
| * ABGs
| |
| * D-dimer
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CXR
| |
| * V/Q scan
| |
| * Spiral [[CT pulmonary angiogram]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Dyspnea
| |
| * Tachycardia
| |
| * Pleuretic chest pain
| |
| |-
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ/LUQ
| |
| | 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" |Normal or hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ABGs
| |
| * Leukocytosis
| |
| * Pancytopenia
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *CXR
| |
| *CT chest
| |
| *Bronchoscopy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Shortness of breath
| |
| * Cough
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cardiovascular disorders
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial Infarction]]
| |
| | 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" | Positive in cardiogenic shock
| |
| | 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" |
| |
| * [[Cardiac enzymes]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[ECG]]
| |
| [[Echocardiogram]]
| |
| * Wall motion abnormality
| |
| * Wall rupture
| |
| * Septal rupture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Chest pain, tightness, diaphoresis
| |
| Complications:
| |
| * [[Arrythmias]]
| |
| * [[Mitral regurgitation]]
| |
| * Ventricular wall rupture
| |
| * Septal rupture
| |
| |- | | |- |
| |} | | |} |
| |}
| |
| </small></small>
| |
|
| |
| == Diagnostic workup ==
| |
|
| |
|
| |
|
| |
|
| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| | {{WikiDoc Help Menu}} |
| | {{WikiDoc Sources}} |
| | <references /> |
| | |
| [[Category:Hepatology]] | | [[Category:Hepatology]] |
| [[Category:Medical signs]] | | [[Category:Medical signs]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Primary care]]
| |
|
| |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |
| <references />
| |
