|
|
Line 7: |
Line 7: |
| Budd-Chiari syndrome should be differentiated from other causes of [[hepatic failure]] like [[viral hepatitis]] and [[liver cirrhosis]]. The differential diagnosis is as follows: | | Budd-Chiari syndrome should be differentiated from other causes of [[hepatic failure]] like [[viral hepatitis]] and [[liver cirrhosis]]. The differential diagnosis is as follows: |
|
| |
|
| <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]]
| |
| </span>
| |
| <br>
| |
|
| |
| {| align="center"
| |
| |-
| |
| |
| |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| |
| ! colspan="3" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Classification of acute abdomen based on etiology
| |
| ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
| |
| ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
| |
| ! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
| |
| ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Comments
| |
| |-
| |
| ! colspan="4" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Symptoms
| |
| ! colspan="4" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Signs
| |
| |-
| |
| ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" | Fever
| |
| ! 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;" |Hypo-
| |
| tension
| |
| ! 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
| |
| |-
| |
| ! rowspan="38" align="center" style="background:#4479BA; color: #FFFFFF;" |Abdominal causes
| |
| ! colspan="1" rowspan="26" 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 [[Cholangitis|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="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|/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="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|Biliary drainage]] ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) + [[Antibiotics|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="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="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="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Increased [[Anti-mitochondrial antibody|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="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
| |
| * [[Cardiolipin|Anti-cardiolipin antibody]]
| |
| | 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" |[[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="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="5" 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" | + 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|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" |
| |
| | 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="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="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" | +
| |
| | 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" |
| |
| |-
| |
| ! rowspan="8" 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" | + in [[Appendicitis|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" | +
| |
| | 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" |
| |
| | 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="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="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="left" |Hypoactive
| |
| | 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" |[[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="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="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" |
| |
| |-
| |
| ! 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="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" | + 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" |'''−'''
| |
| | 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" |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]] may 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" | + 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<br> >240 μg/L SF <br>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" |
| |
| | 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="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="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" |<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="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="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" |−
| |
| | 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" |<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" |−
| |
| | 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" |−
| |
| | 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="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="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="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="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" align="center" style="background:#4479BA; color: #FFFFFF;" |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="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" | + 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>[[Image:Right_upper_quadrant.PNG|link=Right upper quadrant abdominal pain resident survival guide|339x339px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Epigastric_quadrant_pain.PNG|link=Epigastric pain resident survival guide|179x179px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Left_upper_quadrant.PNG|link=Left upper quadrant abdominal pain resident survival guide|329x329px]]</figure-inline></figure-inline>
| |
| |-
| |
| | <figure-inline class="mw-default-size"><figure-inline>[[Image:Right_flank_quadrant.PNG|link=Right flank pain resident survival guide|338x338px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Umbilical_pain.PNG|link=Umbilical region pain resident survival guide|165x165px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Left_flank_quadrant.PNG|link=Left flank quadrant abdominal pain resident survival guide|335x335px]]</figure-inline></figure-inline>
| |
| |-
| |
| | <figure-inline class="mw-default-size"><figure-inline>[[Image:Right_lower_quadrant.PNG|link=Right lower quadrant abdominal pain resident survival guide|338x338px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Hypogastric.PNG|link=Hypogastric pain resident survival guide|199x199px]]</figure-inline></figure-inline>||<figure-inline class="mw-default-size"><figure-inline>[[Image:Left_lower_quadrant.PNG|link=Left lower quadrant abdominal pain resident survival guide|335x335px]]</figure-inline></figure-inline>
| |
| |}
| |
|
| |
|
| | For differential diagnosis of abdominal pain, click here. |
| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |