Ileus differential diagnosis: Difference between revisions

Latest revision as of 20:20, 13 January 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Ileus must be differentiated from other diseases that cause abdominal pain, constipation, nausea and vomiting such as small bowel obstruction, gastric outlet obstruction, gastroparesis, gastrointestinal perforation, acute cholecystitis, acute pancreatitis, chronic pancreatitis, liver abscess and spontaneous bacterial peritonitis.

Differential Diagnosis

Ileus must be differentiated from other diseases that cause abdominal pain, constipation, nausea and vomiting. The differentials include the following:^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]

Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function tests, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X-ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram, US = Ultrasound

	Abdominal Pain	Fever	Rigors and chills	Nausea or vomiting	Jaundice	Constipation	Diarrhea	Weight loss	GI bleeding	Hypotension	Guarding	Rebound Tenderness	Bowel sounds	Lab Findings	Imaging
Disease	Clinical manifestations													Diagnosis		Comments
	Symptoms									Signs				Diagnosis
Ileus	Diffuse	-	-	+	-	+	-	±	-	+	-	±	Hypoactive	Electrolyte abnormalities such as hypokalemia, hypomagnesemia, hyponatremia Increased WBC	Multiple air–fluid levels throughout the abdomen Dilatation of both the large and small intestine	Hypoactive bowel sounds Most commonly seen in the postoperative state
Small bowel obstruction	Diffuse	+	−	+	−	+	−	+	−	+	+	±	Hyperactive then absent	Leukocytosis with left shift indicates complications	Abdominal X-ray Dilated loops of the bowel with air-fluid levels Gasless abdomen	"Target sign"– , indicative of intussusception Venous cut-off sign" – suggests thrombosis
Gastric outlet obstruction	Epigastric	−	−	±	−	−	−	+	−	−	−	−	Hyperactive	Complete blood count Basic metabolic panel	Abdominal x-ray- air-fluid level Barium upper GI studies- narrowed pylorus	Succussion splash
Gastroparesis	Epigastric	−	−	+	−	−	−	+	−	±	−	−	Hyperactive/hypoactive	Hemoglobin Fasting plasma glucose Serum total protein, albumin, thyrotropin (TSH), and an antinuclear antibody (ANA) titer HbA1c	Scintigraphic gastric emptying	Succussion splash Single photon emission computed tomography (SPECT) Full thickness gastric and small intestinal biopsy
Gastrointestinal perforation	Diffuse	+	±	-	±	−	−	−	+	+	+	±	Hyperactive/hypoactive	WBC> 10,000	Air under diaphragm in upright CXR	Hamman's sign
Disease	Abdominal Pain	Fever	Rigors and chills	Nausea or vomiting	Jaundice	Constipation	Diarrhea	Weight loss	GI bleeding	Hypotension	Guarding	Rebound Tenderness	Bowel sounds	Lab Findings	Imaging	Comments
Acute cholecystitis	RUQ	+	−	+	+	−	−	−	−	−	−	−	Hypoactive	Hyperbilirubinemia Leukocytosis	Ultrasound shows: Gallstone Inflammation	Murphy’s sign
Acute pancreatitis	Epigastric	+	−	+	±	−	−	+	−	±	−	−	N	Increased amylase / lipase	Ultrasound shows evidence of inflammation CT scan shows severity of pancreatitis	Pain radiation to back
Chronic pancreatitis	Epigastric	−	−	±	±	−	+	+	−	−	−	−	N	Increased amylase / lipase Increased stool fat content Pancreatic function test	CT scan Calcification Pseudocyst Dilation of main Pancreatic duct	Predisposes to pancreatic cancer
Liver abscess	RUQ	+	+	+	+	−	±	+	−	+	+	±	Normal or hypoactive	CBC Blood culture Abnormal liver function tests	CT scan shows cluster sign Ultrasound is the gold standard technique for diagnosing amoebic liver abscess	Both lobes are commonly involved
Spontaneous bacterial peritonitis	Diffuse	+	−	−	Positive in cirrhotic patients	−	+	−	−	±	+	+	Hypoactive	Ascitic fluid PMN>250 cells/mm³ Culture: Positive for single organism	Ultrasound for evaluation of liver cirrhosis

References

↑ Johnson CD, Ellis H (1990). "Gastric outlet obstruction now predicts malignancy". Br J Surg. 77 (9): 1023–4. PMID 2207566.
↑ Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS (1995). "Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers". Am. J. Gastroenterol. 90 (10): 1769–70. PMID 7572891.
↑ Cappell MS, Davis M (2006). "Characterization of Bouveret's syndrome: a comprehensive review of 128 cases". Am. J. Gastroenterol. 101 (9): 2139–46. doi:10.1111/j.1572-0241.2006.00645.x. PMID 16817848.
↑ Dubois A, Price SF, Castell DO (1978). "Gastric retention in peptic ulcer disease. A reappraisal". Am J Dig Dis. 23 (11): 993–7. PMID 717362.
↑ "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". Retrieved 22 September 2012.
↑ Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T (1984). "Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy". Scand J Gastroenterol. 19 (1): 31–7. PMID 6710074.
↑ Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 15–26. doi:10.1007/s00534-006-1152-y. PMC 2784509. PMID 17252293.
↑ Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS; et al. (2012). "Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation". Ann Surg. 256 (6): 875–80. doi:10.1097/SLA.0b013e318256f778. PMID 22735715.
↑ Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.

Template:WS Template:WH

[pmid2207566-1] Johnson CD, Ellis H (1990). "Gastric outlet obstruction now predicts malignancy". Br J Surg. 77 (9): 1023–4. PMID 2207566.

[pmid7572891-2] Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS (1995). "Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers". Am. J. Gastroenterol. 90 (10): 1769–70. PMID 7572891.

[pmid16817848-3] Cappell MS, Davis M (2006). "Characterization of Bouveret's syndrome: a comprehensive review of 128 cases". Am. J. Gastroenterol. 101 (9): 2139–46. doi:10.1111/j.1572-0241.2006.00645.x. PMID 16817848.

[pmid717362-4] Dubois A, Price SF, Castell DO (1978). "Gastric retention in peptic ulcer disease. A reappraisal". Am J Dig Dis. 23 (11): 993–7. PMID 717362.

[www.ncbi.nlm.nih.gov-5] "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". Retrieved 22 September 2012.

[pmid6710074-6] Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T (1984). "Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy". Scand J Gastroenterol. 19 (1): 31–7. PMID 6710074.

[pmid17252293-7] Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 15–26. doi:10.1007/s00534-006-1152-y. PMC 2784509. PMID 17252293.

[pmid22735715-8] Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS; et al. (2012). "Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation". Ann Surg. 256 (6): 875–80. doi:10.1097/SLA.0b013e318256f778. PMID 22735715.

[pmid23100216-9] Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Ileus}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Ileus]]
 {{CMG}};{{AE}}{{Akshun}}
 ==Overview==
+[[Ileus]] must be differentiated from other [[disease|diseases]] that cause [[abdominal pain]], [[constipation]], [[nausea and vomiting]] such as [[small bowel obstruction]], [[gastric outlet obstruction]], [[gastroparesis]], [[gastrointestinal perforation]], [[acute cholecystitis]], [[acute pancreatitis]], [[chronic pancreatitis]], [[liver abscess]] and [[spontaneous bacterial peritonitis]].
 ==Differential Diagnosis==
-Ileus must be differentiated from other diseases that cause abdominal pain, constipation, nausea and vomiting.
+[[Ileus]] must be differentiated from other [[disease|diseases]] that cause [[abdominal pain]], [[constipation]], [[nausea and vomiting]]. The differentials include the following:<ref name="pmid2207566">{{cite journal |vauthors=Johnson CD, Ellis H |title=Gastric outlet obstruction now predicts malignancy |journal=Br J Surg |volume=77 |issue=9 |pages=1023–4 |year=1990 |pmid=2207566 |doi= |url=}}</ref><ref name="pmid7572891">{{cite journal |vauthors=Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS |title=Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers |journal=Am. J. Gastroenterol. |volume=90 |issue=10 |pages=1769–70 |year=1995 |pmid=7572891 |doi= |url=}}</ref><ref name="pmid16817848">{{cite journal |vauthors=Cappell MS, Davis M |title=Characterization of Bouveret's syndrome: a comprehensive review of 128 cases |journal=Am. J. Gastroenterol. |volume=101 |issue=9 |pages=2139–46 |year=2006 |pmid=16817848 |doi=10.1111/j.1572-0241.2006.00645.x |url=}}</ref><ref name="pmid717362">{{cite journal |vauthors=Dubois A, Price SF, Castell DO |title=Gastric retention in peptic ulcer disease. A reappraisal |journal=Am J Dig Dis |volume=23 |issue=11 |pages=993–7 |year=1978 |pmid=717362 |doi= |url=}}</ref><ref name="www.ncbi.nlm.nih.gov">{{Cite web  | last =  | first =  | title = Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784509/ | publisher =  | date =  | accessdate = 22 September 2012 }}</ref><ref name="pmid6710074">{{cite journal| author=Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T| title=Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy. | journal=Scand J Gastroenterol | year= 1984 | volume= 19 | issue= 1 | pages= 31-7 | pmid=6710074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6710074  }} </ref><ref name="pmid17252293">{{cite journal |vauthors=Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR |title=Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines |journal=J Hepatobiliary Pancreat Surg |volume=14 |issue=1 |pages=15–26 |year=2007 |pmid=17252293 |pmc=2784509 |doi=10.1007/s00534-006-1152-y |url=}}</ref><ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref>
 <span style="font-size:85%">'''Abbreviations:'''
-'''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''IV'''= Intravenous, '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CXR'''= Chest X ray, '''IgA'''= [[Immunoglobulin A]], '''IgG'''= [[Immunoglobulin G]], '''IgM'''= [[Immunoglobulin M]], '''CT'''= [[Computed tomography]], '''[[PMN]]'''= Polymorphonuclear cells, '''[[ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[CRP]]'''= [[C-reactive protein]], TS= [[Transferrin saturation]], SF= Serum [[Ferritin]], SMA= [[Superior mesenteric artery]], SMV= [[Superior mesenteric vein]], ECG= [[Electrocardiogram]], US = [[Ultrasound]]</span>
+'''[[RUQ]]'''= Right upper quadrant of the [[abdomen]], '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''[[Liver function tests|LFT]]'''= [[Liver function tests]], [[Systemic inflammatory response syndrome|SIRS]]= [[Systemic inflammatory response syndrome]], '''[[Endoscopic retrograde cholangiopancreatography|ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''[[Intravenous|IV]]'''= [[Intravenous]], '''N'''= Normal, '''AMA'''= [[Anti-mitochondrial antibody|Anti mitochondrial antibodies]], '''[[Lactate dehydrogenase|LDH]]'''= [[Lactate dehydrogenase]], '''[[Gastrointestinal tract|GI]]'''= [[Gastrointestinal tract|Gastrointestinal]], '''[[Chest X-ray|CXR]]'''= [[Chest X-ray]], '''[[Immunoglobulin A|IgA]]'''= [[Immunoglobulin A]], '''[[Immunoglobulin G|IgG]]'''= [[Immunoglobulin G]], '''[[Immunoglobulin M|IgM]]'''= [[Immunoglobulin M]], '''[[Computed tomography|CT]]'''= [[Computed tomography]], '''[[PMN]]'''= [[PMN|Polymorphonuclear cells]], '''[[Erythrocyte sedimentation rate|ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[C-reactive protein|CRP]]'''= [[C-reactive protein]], [[Transferrin saturation|TS]]= [[Transferrin saturation]], SF= Serum [[Ferritin]], [[Superior mesenteric artery|SMA]]= [[Superior mesenteric artery]], [[Superior mesenteric vein|SMV]]= [[Superior mesenteric vein]], [[Electrocardiogram|ECG]]= [[Electrocardiogram]], [[Ultrasound|US]] = [[Ultrasound]]</span>
+<small>
 {| align="center"
 |-
 |
 {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
-! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
+! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |[[Disease]]
 | colspan="13" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations'''
-! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis
+! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |[[Diagnosis]]
 ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
 |-
-| colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms'''
+| colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''[[symptom|Symptoms]]'''
 ! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
 |-
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[abdomen|Abdominal]] [[Pain]]
-! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever
+! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | [[Fever]]
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Nausea or vomiting]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Jaundice]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Constipation]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Diarrhea]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Weight loss]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Gastrointestinal bleeding|GI bleeding]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Hypotension]]
-tension
 ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Guarding
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Rebound Tenderness]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Stomach rumble|Bowel sounds]]
 ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ileus]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" | Hypoactive
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Electrolyte disturbance|Electrolyte abnormalities]] such as [[hypokalemia]], [[hypomagnesemia]], [[hyponatremia]]
+* Increased [[White blood cells|WBC]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Multiple air–fluid levels throughout the abdomen
+* Dilatation of both the large and small intestine
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Hypoactive bowel sounds
+* Most commonly seen in the postoperative state
 |-
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Small bowel obstruction]]
@@ Line 56: / Line 81: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 * [[Leukocytosis]] with left shift indicates complications
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal X-ray|Abdominal X ray]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Dilated loops of bowel with air fluid levels
+*[[Abdominal X-ray|Abdominal X-ray]]
-* Gasless abdomen
+* Dilated loops of the bowel with air-fluid levels
+* Gasless [[abdomen]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 * "Target sign"– , indicative of intussusception
-* Venous cut-off sign" –  suggests thrombosis
+* Venous cut-off sign" – suggests [[thrombosis]]
-|-
-| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Ileus
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" | Hypoactive
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-* Electrolyte abnormalities such as hypokalemia, hypomagnesemia hyponatremia
-* Increased WBC
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-* Multiple air–fluid levels throughout the abdomen
-* Dilatation of both large and small intestine
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-* Hypoactive bowel sounds
-* Most commonly seen in postoperative state
 |-
 | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastric outlet obstruction|Gastric outlet obstruction]]
@@ Line 106: / Line 107: @@
 * [[Basic metabolic panel]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* [[Abdominal x-ray]]- air fluid level
+* [[Abdominal x-ray]]- air-fluid level
 * Barium [[Upper GI series|upper GI studies]]- narrowed pylorus
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
@@ Line 127: / Line 128: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 *[[Hemoglobin]]
-*Fasting plasma glucose
+*Fasting [[blood sugar|plasma glucose]]
-*Serum total protein, albumin, [[thyrotropin]] ([[Thyroid-stimulating hormone|TSH]]), and an [[antinuclear antibody]] (ANA) titer
+*Serum total [[protein]], [[albumin]], [[thyrotropin]] ([[Thyroid-stimulating hormone|TSH]]), and an [[antinuclear antibody]] ([[antinuclear antibody|ANA]]) titer
-*[[HbA1c]]
+*[[Glycosylated hemoglobin|HbA1c]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 *Scintigraphic gastric emptying
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 *Succussion splash
-*Single photon emission computed tomography (SPECT)
+*[[Single photon emission computed tomography]] ([[Single photon emission computed tomography|SPECT]])
-*Full thickness gastric and small intestinal biopsy
+*Full thickness gastric and small [[intestine|intestinal]] [[biopsy]]
 |-
 | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastrointestinal perforation]]
@@ Line 152: / Line 153: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive/hypoactive
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* WBC> 10,000
+* [[White blood cells|WBC]]> 10,000
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 * Air under [[diaphragm]] in upright [[CXR]]
@@ Line 159: / Line 160: @@
 |-
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Abdominal Pain]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Fever]]
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Nausea or vomiting]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Jaundice]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Constipation]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Diarrhea]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Weight loss]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Gastrointestinal bleeding|GI bleeding]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Hypotension]]
-tension
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[Rebound Tenderness]]
-! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
+! style="background:#4479BA; color: #FFFFFF;" align="center" |[[intestine|Bowel]] sounds
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
@@ Line 194: / Line 194: @@
 * [[Hyperbilirubinemia]]
 * [[Leukocytosis]]
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound shows:
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Ultrasound]] shows:
-* Gallstone
+* [[Gallstone disease|Gallstone]]
-* Inflammation
+* [[Inflammation]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 * [[Murphy's sign|Murphy’s sign]]
@@ Line 217: / Line 217: @@
 * Increased [[amylase]] / [[lipase]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Ultrasound shows evidence of [[inflammation]]
+* [[Ultrasound]] shows evidence of [[inflammation]]
-* CT scan shows severity of pancreatitis
+* [[Computed tomography|CT scan]] shows severity of [[pancreatitis]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Pain radiation to back
+* [[Pain]] radiation to back
 |-
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chronic pancreatitis]]
@@ Line 239: / Line 239: @@
 * Increased [[amylase]] / [[lipase]]
 * Increased stool fat content
-* Pancreatic function test
+* [[pancreas|Pancreatic]] function test
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
-* Calcification
-* Pseudocyst
-* Dilation of main pancreatic duct
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Predisposes to pancreatic cancer
+*[[Computed tomography|CT scan]]
+* [[Calcification]]
+* [[Pseudocyst]]
+* Dilation of main [[pancreas|Pancreatic]] duct
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Predisposes to [[pancreatic cancer]]
 |-
 | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]]
@@ Line 262: / Line 263: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hypoactive
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* CBC
+* [[Complete blood count|CBC]]
-* Blood cultures
+* [[Blood culture]]
 * Abnormal [[Liver function test|liver function tests]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* US
+* [[CT scan]] shows cluster sign
-* CT
+* [[Ultrasound]] is the gold standard technique for [[diagnosis|diagnosing]] [[amoebic liver abscess]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Both lobes are commonly involved
 |-
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Spontaneous bacterial peritonitis]]
@@ Line 275: / Line 277: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in cirrhotic patients
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in [[cirrhosis|cirrhotic]] [[patient|patients]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 285: / Line 287: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Ascitic fluid [[PMN]]>250 cells/mm<small>³</small>
+* [[Ascites|Ascitic fluid]] [[PMN]]>250 cells/mm<small>³</small>
-* Culture: Positive for single organism
+* Culture: Positive for single [[organism]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* Ultrasound for evaluation of liver cirrhosis
+* [[Ultrasound]] for evaluation of [[cirrhosis|liver cirrhosis]]
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 |-
 |}
 |}
+</small>
 ==References==
 {{Reflist|2}}
+{{WS}}
+{{WH}}
 [[Category:Medicine]]
 [[Category:Gastroenterology]]
 [[Category:Up-To-Date]]
+[[Category:Up-To-Date]]
-[[Category:Primary care]]
-{{WS}}
-{{WH}}

Ileus differential diagnosis: Difference between revisions

Latest revision as of 20:20, 13 January 2021

Overview

Differential Diagnosis

References

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