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
