Gallstone disease differential diagnosis: Difference between revisions

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Revision as of 16:21, 27 November 2017

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

Overview

Gallstone disease must be differentiated from other diseases that cause epigastric and left and right hypochondriac pain such as: Abdominal pain, esophageal chest pain,gastroesophageal reflux disorder, peptic ulcer disease, non-ulcer dyspepsia,hepatitis, functional gallbladder disorder, sphincter of Oddi dysfunction,Chronic pancreatitis, Irritable bowel syndrome, ischemic heart disease, Pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis

Differentiating Gallstone disease from other Diseases

As Gallstone disease manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary disorders. It has been shown that this feature is predictive of finding stones on imaging. ^[1]

However, it is important to note that biliary colic concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.

Laboratory studies can be helpful, along side clinical presentation in making a preliminary diagnosis:

Liver biochemical tests (serum aminotransferases, total bilirubin, alkaline phosphatase), which may be abnormal in patients with hepatitis, biliary tract obstruction, or (less commonly) acute cholecystitis
Serum amylase and lipase, which are elevated in acute pancreatitis
Complete blood count, which may show an elevated white blood cell count in patients with acute cholecystitis or acute cholangitis
Urine analysis, which may show indicate a urinary tract infection or ureteral calculi

Other tests that may be indicated depending upon the patient's symptoms and history including:

Upper endoscopy to look for peptic ulcer disease
Endoscopic ultrasonography to look for chronic pancreatitis
Endoscopic retrograde cholangiopancreatography (ERCP) with sphincter of Oddi manometry to look for sphincter of Oddi dysfunction
Cholescintigraphy with or without cholecystokinin (CCK)-stimulation to look for acute cholecystitis and functional gallbladder disorder, respectively
Testing for ischemic heart disease
Esophageal manometry to look for esophageal sources of chest pain, such as esophageal spasm

References

↑ Kraag N, Thijs C, Knipschild P (1995). "Dyspepsia--how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance". Scand. J. Gastroenterol. 30 (5): 411–21. PMID 7638565.

Template:WH Template:WS |}

[pmid7638565-1] Kraag N, Thijs C, Knipschild P (1995). "Dyspepsia--how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance". Scand. J. Gastroenterol. 30 (5): 411–21. PMID 7638565.

[1]

@@ Line 13: / Line 13: @@
 Laboratory studies can be helpful, along side clinical presentation in making a preliminary diagnosis:
-<span style="font-size:85%">'''Abbreviations:'''
+*Liver biochemical tests (serum aminotransferases, total bilirubin, alkaline phosphatase), which may be abnormal in patients with hepatitis, biliary tract obstruction, or (less commonly) acute cholecystitis
-'''[[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]]
+*Serum amylase and lipase, which are elevated in acute pancreatitis
-</span>
+*Complete blood count, which may show an elevated white blood cell count in patients with acute cholecystitis or acute cholangitis
-{| align="center"
+*Urine analysis, which may show indicate a urinary tract infection or ureteral calculi
-|-
-|
-{| 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" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
-! colspan="10" style="background:#4479BA; color: #FFFFFF;" align="center" |Clinical manifestations
-! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis
-! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
-|-
-! colspan="6" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Symptoms
-! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
-|-
-! 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" |Abdominal Pain
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
-! style="background:#4479BA; color: #FFFFFF;" align="center" |GI Bleed
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
-tension
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Guarding
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
-|-
-! rowspan="40" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal causes
-! colspan="1" rowspan="28" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Inflammatory causes
-! rowspan="7" 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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| 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="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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| 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="left" |Hypoactive
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[Hyperbilirubinemia]]
-* [[Leukocytosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound shows gallstone and evidence of 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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="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]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Pain radiation to back
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary biliary cirrhosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Increased AMA level, abnormal [[LFTs]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary sclerosing cholangitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Increased liver enzymes
-* Increased [[IgM]], [[IgG]]4
-* [[Anti-neutrophil cytoplasmic antibody]] ([[p-ANCA]])
-* [[Anti-nuclear antibody]] ([[ANA]])
-* [[Anti-smooth muscle antibody]] (Anti-Sm)
-* Anti-endothelial antibody
-* Anti-cardiolipin antibody
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |ERCP and MRCP shows
-* Multiple segmental [[strictures]]
-* Mural irregularities
-* [[Biliary]] dilatation and diverticula
-* Distortion of biliary tree
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |The risk of [[cholangiocarcinoma]] in patients with primary sclerosing cholangitis is 400 times higher than the risk in the general population.
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cholelithiasis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N 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" |[[Murphy's sign|Murphy’s sign]]
-|-
-! colspan="1" rowspan="6" 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" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" |
-* Gastric ulcer- [[melena]] and [[hematemesis]]
-* Duodenal ulcer- [[melena]] and [[hematochezia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + in perforated
-| 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" |
-* 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="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastritis|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" |[[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" | + 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="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastroesophageal reflux disease|Gastroesophageal reflux disease]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastric outlet obstruction|Gastric outlet obstruction]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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="left" |Hyperactive
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastrointestinal perforation]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| 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" | +, depends on site
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |
-| 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" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Dumping syndrome]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Intestinal causes
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute appendicitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +in pyogenic 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + 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" |Ultrasound shows evidence of [[inflammation]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]], [[decreased appetite]]
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diverticulitis|Acute diverticulitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| 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" | [[Hematochezia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |
-* [[Leukocytosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan and ultrasound shows evidence of inflammation
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Inflammatory bowel disease]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" | [[Hematochezia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Irritable bowel syndrome]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Tests done to exclude other diseases as it diagnosis of exclusion
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Tests done to exclude other diseases as it diagnosis of exclusion
-| 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: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[Thrombocytopenia]]
-* [[Hypoalbuminemia]]
-* [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |*[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis.
-Images used to find complications
-*[[Whipple's disease x ray|Chest and joint x-ray]]
-*[[Whipple's disease CT|CT]]
-*[[Whipple's disease MRI|MRI]]
-*[[Whipple's disease ultrasound|Echocardiography]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
-* [[Uveitis]]
-* [[Endocarditis]]
-* [[Encephalitis]]
-* [[Dementia]]
-* [[Hepatosplenomegaly]]
-* [[Arthritis]]
-* [[Ascites]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic megacolon]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |Hypoactive
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[Anemia]]
-*[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]]
-*[[Hypoalbuminemia]]
-*[[Metabolic alkalosis]] associated with a poor [[prognosis]]
-*[[Metabolic acidosis]] secondary to [[ischemic colitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan shows:
-*Dilated [[transverse colon]]
-*Loss of colonic haustrations
-*Segmental parietal thinning
-*[[Intraluminal]] soft-tissue masses
-[[Ultrasound]] shows:
-*Loss of haustra coli of the colon
-*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: #DCDCDC;" align="center" |[[Tropical sprue]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Celiac disease]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±, also [[dermatitis herpetiformis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="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 (increased sounds)
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[IgA]] endomysial antibody
-* [[IgA]] [[tissue transglutaminase]] antibody
-* [[Anti-gliadin antibodies|Anti-gliadin antibody]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infective colitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatic causes
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|Viral hepatitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver mass|Liver masses]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + in [[Liver abscess]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + in sepsis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Budd-Chiari syndrome|Budd-Chiari syndrome]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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" | + in liver failure leading to varices
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-*Elevated [[Aspartate aminotransferase|serum aspartate aminotransferase]] and [[alanine aminotransferase]] levels may be more than five times the upper limit of the normal range.
-*Elevated serum [[alkaline phosphatase]] and [[Bilirubin|bilirubin levels]], decreased [[Albumin|serum albumin level]].
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
-|-
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Findings on [[CT scan]] suggestive of Budd-Chiari syndrome include:
-*Early enhancement of the [[caudate lobe]] and [[central liver]] around the [[Inferior vena cavae|inferior vena cava]]
-*Delayed enhancement of the peripheral [[liver]] with accompanying central low density (flip-flop appearance)
-*Peripheral zones of the [[liver]] show reversed [[portal]] [[venous]] [[blood flow]]
-*In the [[chronic]] phase, there is [[caudate lobe]] enlargement and [[atrophy]] of the [[Liver|peripheral liver]] in affected areas
-|}
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Ascitic tap|Ascitic fluid examination]] shows:
-*[[Total protein]] more than 2.5 g per deciliter
-*[[White blood cells]] are usually less than 500/μL.
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hemochromatosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Dull / aching
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + with infections and GI involvement
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + in cirrhotic patients
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |may be in cardicmyopathy
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-* >60% TS
-* >240 μg/L SF
-* Raised LFT <br>Hyperglycemia
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Ultrasound shows evidence of cirrhosis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''−'''
-| 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" |[[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" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-! 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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + 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="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="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 intestine obstruction
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |Hyperactive then absent
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Leukocytosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal X-ray|Abdominal X ray]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]] associated with [[constipation]], [[Abdominal distension|abdominal distention]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Volvulus]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" |<nowiki>+</nowiki>
-| 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 and [[Abdominal x-ray|abdominal X ray]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]] associated with [[constipation]], [[Abdominal distension|abdominal distention]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Biliary colic]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[bilirubin]] and [[alkaline phosphatase]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Renal colic]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |CT scan and ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Colicky [[abdominal pain]] associated with [[Nausea and vomiting|nausea & vomiting]]
-|-
-! rowspan="4" 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" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Periumbilical
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematochezia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |[[Leukocytosis]] and [[lactic acidosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]], normal physical examination
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ischemic colitis|Acute ischemic colitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| 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" | Massive
-| 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" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]]
-|-
-! rowspan="2" 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" |Massive
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |CT scan
-| 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" | Massive
-| style="padding: 5px 5px; background: #F5F5F5;" align="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" |[[Anemia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of [[trauma]]
-|-
-! 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
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[ESR]] and [[CRP]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Sudden onset sever pain with [[nausea and vomiting]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Salpingitis|Acute salpingitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| 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="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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[ESR]] and [[CRP]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Sudden onset sever pain with [[nausea and vomiting]]
-|-
-! 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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="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 and [[vaginal bleeding]]
-|-
-! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra-abdominal causes
-! 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" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| 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="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-! 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" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| 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" | + 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" |
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-! style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-|}
-|}
-{|
-|-
-| <figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Right_upper_quadrant.PNG|link=Right upper quadrant abdominal pain resident survival guide|339x339px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Epigastric_quadrant_pain.PNG|link=Epigastric pain resident survival guide|179x179px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Left_upper_quadrant.PNG|link=Left upper quadrant abdominal pain resident survival guide|329x329px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>
-|-
-| <figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Right_flank_quadrant.PNG|link=Right flank pain resident survival guide|338x338px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Umbilical_pain.PNG|link=Umbilical region pain resident survival guide|165x165px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Left_flank_quadrant.PNG|link=Left flank quadrant abdominal pain resident survival guide|335x335px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>
-|-
-| <figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Right_lower_quadrant.PNG|link=Right lower quadrant abdominal pain resident survival guide|338x338px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Hypogastric.PNG|link=Hypogastric pain resident survival guide|199x199px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[Image:Left_lower_quadrant.PNG|link=Left lower quadrant abdominal pain resident survival guide|335x335px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline>
-|}
-*Liver biochemical tests [[Aminotransferases|(serum aminotransferases]], total [[bilirubin]], [[alkaline phosphatase]]), which may be abnormal in patients with [[hepatitis]], biliary tract obstruction, or (less commonly) [[Cholecystitis|acute cholecystitis]]
-*Serum [[amylase]] and [[lipase]], which are elevated in [[acute pancreatitis]]
-*[[Complete blood count]], which may show an elevated white blood cell count in patients with acute cholecystitis or acute [[cholangitis]]
-*Urine analysis, which may show indicate a [[urinary tract infection]] or ureteral calculi
 Other tests that may be indicated depending upon the patient's symptoms and history including:
-*Upper [[endoscopy]] to look for [[Peptic ulcer|peptic ulcer disease]]
+*Upper endoscopy to look for peptic ulcer disease
-*[[Medical ultrasonography|Endoscopic ultrasonography]] to look for [[chronic pancreatitis]]
+*Endoscopic ultrasonography to look for chronic pancreatitis
-*Endoscopic retrograde cholangiopancreatography ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) with [[sphincter of Oddi]] [[Esophageal motility study|manometry]] to look for [[sphincter of Oddi dysfunction]]
+*Endoscopic retrograde cholangiopancreatography (ERCP) with sphincter of Oddi manometry to look for sphincter of Oddi dysfunction
-*[[HIDA scan|Cholescintigraphy]] with or without cholecystokinin ([[Cholecystokinin receptor|CCK]])-stimulation to look for [[Cholecystitis|acute cholecystitis]] and functional gallbladder disorder, respectively
+*Cholescintigraphy with or without cholecystokinin (CCK)-stimulation to look for acute cholecystitis and functional gallbladder disorder, respectively
-*Testing for [[Coronary heart disease|ischemic heart disease]]
+*Testing for ischemic heart disease
-*Esophageal [[Esophageal motility study|manometry]] to look for esophageal sources of chest pain, such as [[Nutcracker esophagus|esophageal spasm]]
+*Esophageal manometry to look for esophageal sources of chest pain, such as esophageal spasm
-{| align="center"
-|-
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
-! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" | Classification of acute abdomen based
-on etiology
-! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Presentation
-! colspan="8" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Clinical findings
-! colspan="2" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Diagnosis
-! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" | Comments
-|-
-! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Fever
-! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Rigors and Chills
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Abdominal Pain
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Jaundice
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Hypotension
-! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Guarding
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Rebound Tenderness
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Bowel sounds
-! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Lab Findings
-! align="center" style="background:#4479BA; color: #FFFFFF;" |Imaging
-|-
-| colspan="2" rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Common causes of
-Peritonitis
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Spontaneous bacterial peritonitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-|−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| 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" |<nowiki>-</nowiki>
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Perforated [[Gastric ulcer|gastric]] and [[duodenal ulcer]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| 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
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Acute suppurative cholangitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[RUQ]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Acute cholangitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-|−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | [[RUQ]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-|−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| 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
-| 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="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | [[RUQ]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| 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 and evidence of 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="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | [[Epigastric]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| 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]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Pain radiation to back
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute appendicitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | RLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| 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" |Ultrasound shows evidence of [[inflammation]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]], [[decreased appetite]]
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Diverticulitis|Acute diverticulitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | LLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| 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 and ultrasound shows evidence of inflammation
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| colspan="2" rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Hollow Viscous Obstruction
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Small intestine obstruction
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| 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|Abdominal X ray]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]] associated with [[constipation]], [[Abdominal distension|abdominal distention]]
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gall stone disease|Gall stone '''disease''']]/'''Cholelithiasis'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Volvulus]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>+</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| 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 and [[Abdominal x-ray|abdominal X ray]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]] associated with [[constipation]], [[Abdominal distension|abdominal distention]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Biliary colic]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |RUQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[bilirubin]] and [[alkaline phosphatase]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Renal colic]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Flank pain]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| 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" |CT scan and ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Colicky [[abdominal pain]] associated with [[Nausea and vomiting|nausea & vomiting]]
-|-
-| rowspan="4" 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="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Periumbilical
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Leukocytosis]] and [[lactic acidosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]], normal physical examination
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ischemic colitis|Acute ischemic colitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>+</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<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" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Nausea and vomiting|Nausea & vomiting]]
-|-
-| rowspan="2" 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="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| 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" |CT scan
-| 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="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Anemia]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of [[trauma]]
-|-
-| rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Gynaecological Causes
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Fallopian tube
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Salpingitis|Acute salpingitis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | LLQ/ RLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |−
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| 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]]
-|-
-| rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ovarian cyst]] complications and endometrial disease
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Torsion of the cyst
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |RLQ / LLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[ESR]] and [[CRP]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Sudden onset sever pain with [[nausea and vomiting]]
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Endometriosis
-| -
-|
-|RLQ/LLQ
-| -
-|
-| +/-
-| +/-
-|N
-|Normal
-|Laproscopy
-|Menstrual-associated symptoms, pelvic
-symptoms
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cyst rupture
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |RLQ / LLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>+/-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>+/-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[ESR]] and [[CRP]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Sudden onset sever pain with [[nausea and vomiting]]
-|-
-| 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="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |RLQ / LLQ
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| 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 and [[vaginal bleeding]]
-|-
-| rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Functional
-| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Irritable Bowel Syndrome
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |<nowiki>-</nowiki>
-| align="left" style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-[[Diagnosis|Clinical diagnosis]]
-* ROME III/IV criteria
-* [[Pharmacological|Pharmacologic]] studies based criteria
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* High [[dietary fiber]]
-* [[Osmotic]] [[laxatives]]
-* [[Antispasmodic]]<nowiki/>drugs
-|-
-|}
 ==References==

Gallstone disease differential diagnosis: Difference between revisions

Revision as of 16:21, 27 November 2017

Overview

Differentiating Gallstone disease from other Diseases

References

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