Examining the abdomen Flashcards
when is hamatemesis seen?
upper GI bleed
when is projectile vomiting seen?
pyloric stenosis
- commonly in babies
when is feculent vomiting seen?
in severe large bowel obstruction
when is bilious (green)vomiting seen?
in newborn - sign of intestinal obstruction
in adult- sign of obstruction distal to the duodenum
what do rigors suggest?
sepsis e.g. due to an abscess, cholangitis or UTI
what does a change in bowel habit suggest?
- absolute constipation (no faeces or wind passed) suggests complete bowel obstruction
- diarrhoea can be caused by gastroenteritis and diverticulitis
- constipation alternating with diarrhoea is a sign of colonic malignancy but is also seen in IBS
what does rectal bleeding indicate?
- IBD
- Malignancy
- Diverticulitis
- Dysentery (inflammation of colon, caused by shigella bacillus infection)
- angiodysplasia
what does jaundice suggest?
- hepatitis
- gallstones
- pancreatitis
what does cachexia suggest?
chronic pathology, particularly malignancy
what does clubbing of the fingers suggest?
- IBD
- GI malignancy
- chronic liver disease
what does lymphadenopathy in acute abdomen suggest? which node in particular is affected?
intra-abdominal malignancy
-> left supraclavicular lymph node (Virchow’s node) is especially affected in intra-abdominal malignancies)
what is Cullen’s sign and what does it suggest?
periumbilical or central bruising
- ruptured ectopic pregnancy
- severe haemorrhagic pancreatitis
- leaking AAA
what is Grey Turner’s sign?
bruising in the flanks (can be accompanied by Cullen’s sign)
- ruptured ectopic pregnancy
- pancreatic haemorrhage (acute pancreatitis?)
- ruptured AAA
what must you consider as a cause of pain in a patient with an abdominal surgical scar?
new - anastomotic leak
old - adhesions
what are anastomotic leaks?
leak of luminal contents from a surgical join
what does abdominal distension suggest?
bowel obstruction
generalised peritonitis
what does ascites suggest?
malignancy
peritoneal sepsis
pancreatitis
portal hypertension
what do high-pitched (tinkling) bowel sounds suggest?
obstruction
what do absent bowel sounds suggest?
ileus (paralysis of bowel)
what examinations are performed to conclude an abdominal examination?
- check hernial orifices
- digital rectal exam
- pelvic exam (women)
- urine dipstick
what is Murphy’s sign?
deep inspiration is halted when two fingers are pressed in the right upper quadrant due to discomfort.
examination in the left upper quadrant does not halt inspiration.
due to cholecystitis
what is Rovsing’s sign?
sudden release of pressure in the left iliac fossa causes pain in the right ilia fossa in appendicitis.
