|
|
| Line 2: |
Line 2: |
| {{CMG}} | | {{CMG}} |
|
| |
|
| == Overview == | | ==[[Abdominal bruit overview|Overview]]== |
| An abdominal bruit is a swishing, or washing machine like sound heard when the diaphragm of [[stethoscope]] is placed over the [[spleen]], [[renal arteries]], or [[abdominal aorta]]. It is often indicative of partial [[stenosis|occlusion of a vessel]], as can be observed in [[renal artery stenosis]] or [[atherosclerosis]] of the abdominal vasculature.
| |
| | |
| ==Causes== | | ==Causes== |
|
| |
| ===Common Causes===
| |
| *[[Cirrhosis]]
| |
| *[[Renal artery]] stenosis
| |
|
| |
| ===Causes by Organ System===
| |
|
| |
| {|style="width:80%; height:100px" border="1"
| |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Abdominal aortic aneurysm]], [[Aortic aneurysm]], [[Arteriovenous malformation]], [[celiac artery|Celiac artery stenosis]], [[Tricuspid regurgitation]], Turbulence of the [[splenic artery]], [[Cruveilhier-Baumgarten murmur]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical / poisoning'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dermatologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| [[Cirrhosis]], [[Cholangiocarcinoma]], [[Hepatic venous hum]], [[Hepatocellular carcinoma (hepatoma)]], [[Hepatoma]], [[hemangioma|Liver hemangioma]], [[metastases|Liver metastases]], [[Superior mesenteric artery]] stenosis, Turbulence of the [[splenic artery]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal / Ortho'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional / Metabolic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"| [[Cholangiocarcinoma]], [[Hepatocellular carcinoma (hepatoma)]], [[Hepatoma]], [[metastases|Liver metastases]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Opthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose / Toxicity'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal / Electrolyte'''
| |
| |bgcolor="Beige"| [[Renal artery stenosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheum / Immune / Allergy'''
| |
| |bgcolor="Beige"| [[Inflammatory processes]], [[Takayasu's Arteritis]], [[Vasculitis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"| Abdominal friction rub
| |
| |-
| |
| |}
| |
|
| |
| ===Causes in Alphabetical Order===
| |
|
| |
| *[[Abdominal aortic aneurysm]]
| |
| *Abdominal friction rub
| |
| *[[Aortic aneurysm]]
| |
| *[[Arteriovenous malformation]]
| |
| *[[Celiac artery|Celiac artery stenosis]]
| |
| *[[Cholangiocarcinoma]]
| |
| *[[Cirrhosis]]
| |
| *[[Cruveilhier-Baumgarten murmur]]
| |
| *[[Fibromuscular dysplasia]]
| |
| *[[Hepatocellular carcinoma|Hepatocellular carcinoma (hepatic)]]
| |
| *[[Hepatoma]]
| |
| *[[Inflammatory processes]]
| |
| *[[Hemangioma|Liver hemangioma]]
| |
| *[[Metastases|Liver metastases]]
| |
| *[[Renal artery stenosis]]
| |
| *[[Superior mesenteric artery]] stenosis
| |
| *[[Takayasu's Arteritis]]
| |
| *[[Tricuspid regurgitation]]
| |
| *[[Tumor]] that is highly vascularized
| |
| *Turbulence of the [[splenic artery]]
| |
| *[[Vasculitis]]
| |
|
| |
| ==Diagnosis== | | ==Diagnosis== |
|
| |
| === Physical Examination ===
| |
|
| |
| ==== Abdomen ====
| |
| * May have palpable [[thrill]] in addition to the murmur.
| |
|
| |
| === Laboratory Findings ===
| |
| * [[Captopril]] challenge followed by measuring [[renal vein]] [[renin]] levels diagnoses [[renal artery]] stenosis.
| |
| * [[Lipid]] panel for [[arteriosclerosis]]
| |
| * Suspected inflammatory processes:
| |
| *:* [[Erythrocyte sedimentation rate]] ([[ESR]])
| |
| *:* [[Complete blood count]]
| |
| * [[Liver function tests]] ([[LFT]]s) to evaluate liver
| |
|
| |
| === MRI and CT ===
| |
| * [[CT]] of abdomen may be helpful in evaluating underlying [[pathology]].
| |
|
| |
| === Echocardiography or Ultrasound ===
| |
| * [[Ultrasound]] used as initial test
| |
| * [[Medical ultrasonography|Arterial Doppler ultrasound]] helps diagnose
| |
| * [[Echocardiogram]] evaluates valvular dysfunction
| |
|
| |
| === Other Imaging Findings ===
| |
| ==== Angiography ====
| |
| * Can be used to diagnoses stenoses including [[renal artery stenosis]]
| |
|
| |
| === Other Diagnostic Studies ===
| |
| * IV urography or radionuclide nephrograms will show differences in [[kidney]] perfusion with stenotic artery
| |
|
| |
| == Treatment ==
| |
| * In the critically ill patient with a ruptured [[aortic aneurysm]], the first goal is to stabilize the patient and repair the [[aneurysm]] immediately.
| |
| * In the patient with [[renal artery stenosis]], the goal is to treat the [[hypertension]]
| |
| *:* In patients with bilateral stenosis, avoid [[ACE inhibitors]].
| |
| * Treat underlying [[etiology]]
| |
| * Consult [[nephrology]] for appropriate management of [[renal insufficiency]]
| |
| * Consult [[vascular surgery]] for symptomatic and/or severly stenotic vessels
| |
|
| |
| == References ==
| |
| {{Reflist|2}}
| |
|
| |
|
| |
|
| |
|
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |