Short bowel syndrome physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: {{SSH}]
Overview
Patients with short bowel syndrome usually appear weak and tired. Physical examination of patients with short bowel syndrome is usually remarkable for signs of malabsorption, dehydration and abdominal tenderness.
Physical Examination
- Physical examination of patients with short bowel syndrome is usually remarkable for: weakness, dehydration and abdominal tenderness and distention.[1][2] [3] [4] [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]
Appearance of the Patient
- Patients with short bowel syndrome usually appear weak and tired.
Vital Signs
- High-grade / low-grade fever
- Hypothermia may be present
- Tachycardia with regular pulse
- Weak pulse
- Low blood pressure with normal pulse pressure
Skin
HEENT
- Temporal wasting
- Corneal erosion
Abdomen
- Abdominal distention
- Hyperactive bowel sound
- Abdominal tenderness
- Rebound tenderness (positive Blumberg sign)
- Guarding may be present
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Confusion
- Hyporeflexia
- Peripheral neuropathy
- Bilateral extremity weakness
Extremities
- Peripheral edema
- Muscle atrophy
References
- ↑ Rodrigues, Gabriel; Seetharam, Prasad (2011). "Short bowel syndrome: A review of management options". Saudi Journal of Gastroenterology. 17 (4): 229. doi:10.4103/1319-3767.82573. ISSN 1319-3767.
- ↑ Wall, Elizabeth A. (2013). "An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations". Journal of the Academy of Nutrition and Dietetics. 113 (9): 1200–1208. doi:10.1016/j.jand.2013.05.001. ISSN 2212-2672.
- ↑ Botey, Mireia; Alastrué, Antonio; Haetta, Henrik; Fernández-Llamazares, Jaume; Clavell, Arantxa; Moreno, Pau (2017). "Long-Term Results of Serial Transverse Enteroplasty with Neovalve Creation for Extreme Short Bowel Syndrome: Report of Two Cases". Case Reports in Gastroenterology. 11 (1): 229–240. doi:10.1159/000452734. ISSN 1662-0631.
- ↑ Thompson, Jon S.; Weseman, Rebecca; Rochling, Fedja A.; Mercer, David F. (2011). "Current Management of the Short Bowel Syndrome". Surgical Clinics of North America. 91 (3): 493–510. doi:10.1016/j.suc.2011.02.006. ISSN 0039-6109.
- ↑ Eça, Rosário; Barbosa, Elisabete (2016). "Short bowel syndrome: treatment options". Journal of Coloproctology. 36 (4): 262–272. doi:10.1016/j.jcol.2016.07.002. ISSN 2237-9363.
- ↑ Steiger E, DiBaise JK, Messing B, Matarese LE, Blethen S (2006). "Indications and recommendations for the use of recombinant human growth hormone in adult short bowel syndrome patients dependent on parenteral nutrition". J. Clin. Gastroenterol. 40 Suppl 2: S99–106. doi:10.1097/01.mcg.0000212680.52290.02. PMID 16770169.
- ↑ Keller J, Panter H, Layer P (2004). "Management of the short bowel syndrome after extensive small bowel resection". Best Pract Res Clin Gastroenterol. 18 (5): 977–92. doi:10.1016/j.bpg.2004.05.002. PMID 15494290.
- ↑ Misiakos EP, Macheras A, Kapetanakis T, Liakakos T (2007). "Short bowel syndrome: current medical and surgical trends". J. Clin. Gastroenterol. 41 (1): 5–18. doi:10.1097/01.mcg.0000212617.74337.e9. PMID 17198059.
- ↑ Matarese LE, O'Keefe SJ, Kandil HM, Bond G, Costa G, Abu-Elmagd K (2005). "Short bowel syndrome: clinical guidelines for nutrition management". Nutr Clin Pract. 20 (5): 493–502. doi:10.1177/0115426505020005493. PMID 16207689.
- ↑ Limketkai BN, Parian AM, Shah ND, Colombel JF (2016). "Short Bowel Syndrome and Intestinal Failure in Crohn's Disease". Inflamm. Bowel Dis. 22 (5): 1209–18. doi:10.1097/MIB.0000000000000698. PMID 26818425.
- ↑ Malec LM, Cooper J, Rudolph J, Michaels MG, Ragni MV (2017). "Prophylactic rtPA in the Prevention of Line-associated Thrombosis and Infection in Short Bowel Syndrome". J. Pediatr. Gastroenterol. Nutr. doi:10.1097/MPG.0000000000001836. PMID 29135819.
- ↑ Martin LY, Ladd MR, Werts A, Sodhi CP, March JC, Hackam DJ (2017). "Tissue engineering for the treatment of short bowel syndrome in children". Pediatr. Res. doi:10.1038/pr.2017.234. PMID 28937976.
- ↑ Sundaram A, Koutkia P, Apovian CM (2002). "Nutritional management of short bowel syndrome in adults". J. Clin. Gastroenterol. 34 (3): 207–20. PMID 11873098.
- ↑ Tappenden KA (2014). "Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy". JPEN J Parenter Enteral Nutr. 38 (1 Suppl): 14S–22S. doi:10.1177/0148607113520005. PMID 24500909.
- ↑ Vanderhoof JA, Young RJ (2003). "Enteral and parenteral nutrition in the care of patients with short-bowel syndrome". Best Pract Res Clin Gastroenterol. 17 (6): 997–1015. PMID 14642862.
- ↑ Bechtold ML, McClave SA, Palmer LB, Nguyen DL, Urben LM, Martindale RG, Hurt RT (2014). "The pharmacologic treatment of short bowel syndrome: new tricks and novel agents". Curr Gastroenterol Rep. 16 (7): 392. doi:10.1007/s11894-014-0392-2. PMID 25052938.
- ↑ DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 1". Am. J. Gastroenterol. 99 (7): 1386–95. doi:10.1111/j.1572-0241.2004.30345.x. PMID 15233682.
- ↑ DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 2". Am. J. Gastroenterol. 99 (9): 1823–32. doi:10.1111/j.1572-0241.2004.40836.x. PMID 15330926.
- ↑ Matarese LE, Steiger E (2006). "Dietary and medical management of short bowel syndrome in adult patients". J. Clin. Gastroenterol. 40 Suppl 2: S85–93. doi:10.1097/01.mcg.0000212678.14172.7a. PMID 16770167.
- ↑ Kelly DG, Tappenden KA, Winkler MF (2014). "Short bowel syndrome: highlights of patient management, quality of life, and survival". JPEN J Parenter Enteral Nutr. 38 (4): 427–37. doi:10.1177/0148607113512678. PMID 24247092.