Abdominal bruit: Difference between revisions

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== Overview ==
==[[Abdominal bruit overview|Overview]]==
An abdominal bruit is a murmur 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.
==[[Abdominal bruit historical perspective|Historical Perspective]]==
 
==[[Abdominal bruit pathophysiology|Pathophysiology]]==
==Causes==
==[[Abdominal bruit causes|Causes]]==
===Common Causes===
==[[Abdominal bruit differential diagnosis|Differentiating Abdominal bruit from other Diseases]]==
*[[Cirrhosis]]
==[[Abdominal bruit risk factors|Risk Factors]]==
*[[Renal artery]] stenosis
==[[Abdominal_bruit_natural_history,_complications_and_prognosis|Natural History, Complications, and Prognosis]]==
 
===Complete Differential Diagnosis of the Causes of Abdominal Bruit===
(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]]
 
===Complete Differential Diagnosis of the Causes of Abdominal Bruit===
(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
|-
|}
 
==Diagnosis==
==Diagnosis==
=== Physical Examination ====
:[[Abdominal bruit history and symptoms|History and Symptoms]] | [[Abdominal bruit physical examination|Physical Examination]] | [[Abdominal bruit laboratory findings|Laboratory Findings]] | [[Abdominal bruit abdominal x ray|Abdominal X Ray]] | [[Abdominal bruit CT|CT]] | [[Abdominal bruit MRI|MRI]] | [[Abdominal bruit echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Abdominal bruit other imaging findings|Other Imaging Findings]] | [[Abdominal bruit other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
==== Abdomen ====
:[[Abdominal bruit medical therapy|Medical Therapy]] | [[Abdominal bruit surgery|Surgery]] | [[Abdominal bruit primary prevention|Primary Prevention]] | [[Abdominal bruit secondary prevention|Secondary Prevention]] | [[Abdominal bruit cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Abdominal bruit future or investigational therapies|Future or Investigational Therapies]]
* May have palpable [[thrill]] in addition to the murmur.
==Case Studies==
 
:[[Abdominal bruit case study one|Case #1]]
=== 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]] (always).
* Treat underlying [[etiology]]
* Consult [[nephrology]] for appropriate management of [[renal insufficiency]]
* Consult [[vascular surgery]] for symptomatic and/or severly stenotic vessels
 
== References ==
{{Reflist|2}}
 
{{SIB}}


[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
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[[Category:Physical examination]]
[[Category:Physical examination]]


 
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Revision as of 17:45, 4 June 2013

Abdominal bruit Microchapters

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Historical Perspective

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Abdominal X Ray

CT

MRI

Echocardiography and Ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Abdominal bruit from other Diseases

Risk Factors

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Abdominal X Ray | CT | MRI | Echocardiography and Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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