Abdominal distension
| Abdominal distension | |
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| ICD-10 | R14, R19.0 |
| ICD-9 | 787.3, 789.3 |
| DiseasesDB | 30819 |
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Abdominal distension Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Abdominal distension On the Web |
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American Roentgen Ray Society Images of Abdominal distension |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; M.Umer Tariq [3]
Overview
- Abdominal distension must be evaluated carefully and systematically. The first concern is to rule out a serious diagnosis such as abdominal aneurysm.
- Importance of evaluation:
- To rule out serious diagnoses
- To evaluate mundane diagnoses
- Attention to history and physical examination is important to formulate plan of diagnosis
Diagnosis
History
- Diarrhea
- Weight gain
- Duration
- Flatus
- Reflux
- Last bowel movement
- Last menstrual period
- Sexual history
- Presence of fever
- Constitutional symptoms
Physical Examination
- In women, pelvic exam
- Fluid wave
- Signs:
Abdomen
- Abdominal exam
- Masses
- Palpitation for hernias
- Abdominal tenderness
Laboratory Findings
- Complete blood count (CBC)
- Stool cultures
- Pregnancy test
- Erythrocyte sedimentation rate (ESR)
- Liver workup (liver function tests, biopsy, hepatitis panel)
MRI and CT
- Pelvic and abdominal CT scans could reveal:
- Cirrhosis
- Ovarian masses
- Pseudocysts
- Aneurysms
Echocardiography or Ultrasound
- Pelvic and abdominal ultrasound may reveal:
- Ovarian mass
- Pregnancy
- Ascites
- Liver disease
Other Imaging Findings
- KUB x-rays (kidney, ureter, bladder)
- Could reveal paralytic ileus, constipation, air swallowing, bowel obstruction
Other Diagnostic Studies
- Biopsy for masses/tumors
- Endoscopy (lower gastrointestinal) may be performed to rule out any organic pathology before irritable bowel syndrome can be diagnosed.
- Paracentesis may provide symptomatic relief and is diagnostic for spontaneous bacterial peritonitis (SBP) and malignant ascites.
Treatment
- For malabsorption, reduce milk intake and change diet
- For bowel obstruction, pancreatitis (for example), nasogastric tube decompression and bowel rest (when indicated)
- For swallowing air, awareness is key:
- Sip hot beverages
- Avoid carbonated beverages
- Chew gum/suck on candies
- Eat slowly
- Drink through a straw
- Treatment of underlying liver diseases (management of complications)
- Increase dietary fiber, reduce stress, and antispasmodics for irritable bowel syndrome
Acute Pharmacotherapies
- For constipation, laxatives
- For spontaneous bacterial peritonitis (SBP), antibiotics
Surgery and Device Based Therapy
- Referral for hernias (if and when appropriate)