Short bowel syndrome physical examination: Difference between revisions

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{{Short bowel syndrome}}
{{Short bowel syndrome}}


{{CMG}}; {{AE}}<nowiki> {{SSH}]</nowiki>
{{CMG}}; {{AE}} {{SSH}}


==Overview==
==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.  
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 [[Tenderness (medicine)|abdominal tenderness]].  
==Physical Examination==
==Physical Examination==
[[Physical examination]] of patients with short bowel syndrome is usually remarkable for [[weakness]], [[dehydration]] and [[abdominal tenderness]] and [[Abdominal distention|distention]].<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref><ref name="Wall2013">{{cite journal|last1=Wall|first1=Elizabeth A.|title=An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations|journal=Journal of the Academy of Nutrition and Dietetics|volume=113|issue=9|year=2013|pages=1200–1208|issn=22122672|doi=10.1016/j.jand.2013.05.001}}</ref><ref name="EçaBarbosa2016">{{cite journal|last1=Eça|first1=Rosário|last2=Barbosa|first2=Elisabete|title=Short bowel syndrome: treatment options|journal=Journal of Coloproctology|volume=36|issue=4|year=2016|pages=262–272|issn=22379363|doi=10.1016/j.jcol.2016.07.002}}</ref><ref name="pmid17198059">{{cite journal |vauthors=Misiakos EP, Macheras A, Kapetanakis T, Liakakos T |title=Short bowel syndrome: current medical and surgical trends |journal=J. Clin. Gastroenterol. |volume=41 |issue=1 |pages=5–18 |year=2007 |pmid=17198059 |doi=10.1097/01.mcg.0000212617.74337.e9 |url=}}</ref><ref name="pmid16207689">{{cite journal |vauthors=Matarese LE, O'Keefe SJ, Kandil HM, Bond G, Costa G, Abu-Elmagd K |title=Short bowel syndrome: clinical guidelines for nutrition management |journal=Nutr Clin Pract |volume=20 |issue=5 |pages=493–502 |year=2005 |pmid=16207689 |doi=10.1177/0115426505020005493 |url=}}</ref><ref name="pmid15233682">{{cite journal |vauthors=DiBaise JK, Young RJ, Vanderhoof JA |title=Intestinal rehabilitation and the short bowel syndrome: part 1 |journal=Am. J. Gastroenterol. |volume=99 |issue=7 |pages=1386–95 |year=2004 |pmid=15233682 |doi=10.1111/j.1572-0241.2004.30345.x |url=}}</ref><ref name="pmid24247092">{{cite journal |vauthors=Kelly DG, Tappenden KA, Winkler MF |title=Short bowel syndrome: highlights of patient management, quality of life, and survival |journal=JPEN J Parenter Enteral Nutr |volume=38 |issue=4 |pages=427–37 |year=2014 |pmid=24247092 |doi=10.1177/0148607113512678 |url=}}</ref>


*Physical examination of patients with short bowel syndrome is usually remarkable for: [[weakness]], [[dehydration]] and [[abdominal tenderness]] and [[distention]].<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref><ref name="Wall2013">{{cite journal|last1=Wall|first1=Elizabeth A.|title=An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations|journal=Journal of the Academy of Nutrition and Dietetics|volume=113|issue=9|year=2013|pages=1200–1208|issn=22122672|doi=10.1016/j.jand.2013.05.001}}</ref> <ref name="BoteyAlastrué2017">{{cite journal|last1=Botey|first1=Mireia|last2=Alastrué|first2=Antonio|last3=Haetta|first3=Henrik|last4=Fernández-Llamazares|first4=Jaume|last5=Clavell|first5=Arantxa|last6=Moreno|first6=Pau|title=Long-Term Results of Serial Transverse Enteroplasty with Neovalve Creation for Extreme Short Bowel Syndrome: Report of Two Cases|journal=Case Reports in Gastroenterology|volume=11|issue=1|year=2017|pages=229–240|issn=1662-0631|doi=10.1159/000452734}}</ref> <ref name="ThompsonWeseman2011">{{cite journal|last1=Thompson|first1=Jon S.|last2=Weseman|first2=Rebecca|last3=Rochling|first3=Fedja A.|last4=Mercer|first4=David F.|title=Current Management of the Short Bowel Syndrome|journal=Surgical Clinics of North America|volume=91|issue=3|year=2011|pages=493–510|issn=00396109|doi=10.1016/j.suc.2011.02.006}}</ref> <ref name="EçaBarbosa2016">{{cite journal|last1=Eça|first1=Rosário|last2=Barbosa|first2=Elisabete|title=Short bowel syndrome: treatment options|journal=Journal of Coloproctology|volume=36|issue=4|year=2016|pages=262–272|issn=22379363|doi=10.1016/j.jcol.2016.07.002}}</ref><ref name="pmid16770169">{{cite journal |vauthors=Steiger E, DiBaise JK, Messing B, Matarese LE, Blethen S |title=Indications and recommendations for the use of recombinant human growth hormone in adult short bowel syndrome patients dependent on parenteral nutrition |journal=J. Clin. Gastroenterol. |volume=40 Suppl 2 |issue= |pages=S99–106 |year=2006 |pmid=16770169 |doi=10.1097/01.mcg.0000212680.52290.02 |url=}}</ref><ref name="pmid15494290">{{cite journal |vauthors=Keller J, Panter H, Layer P |title=Management of the short bowel syndrome after extensive small bowel resection |journal=Best Pract Res Clin Gastroenterol |volume=18 |issue=5 |pages=977–92 |year=2004 |pmid=15494290 |doi=10.1016/j.bpg.2004.05.002 |url=}}</ref><ref name="pmid17198059">{{cite journal |vauthors=Misiakos EP, Macheras A, Kapetanakis T, Liakakos T |title=Short bowel syndrome: current medical and surgical trends |journal=J. Clin. Gastroenterol. |volume=41 |issue=1 |pages=5–18 |year=2007 |pmid=17198059 |doi=10.1097/01.mcg.0000212617.74337.e9 |url=}}</ref><ref name="pmid16207689">{{cite journal |vauthors=Matarese LE, O'Keefe SJ, Kandil HM, Bond G, Costa G, Abu-Elmagd K |title=Short bowel syndrome: clinical guidelines for nutrition management |journal=Nutr Clin Pract |volume=20 |issue=5 |pages=493–502 |year=2005 |pmid=16207689 |doi=10.1177/0115426505020005493 |url=}}</ref><ref name="pmid26818425">{{cite journal |vauthors=Limketkai BN, Parian AM, Shah ND, Colombel JF |title=Short Bowel Syndrome and Intestinal Failure in Crohn's Disease |journal=Inflamm. Bowel Dis. |volume=22 |issue=5 |pages=1209–18 |year=2016 |pmid=26818425 |doi=10.1097/MIB.0000000000000698 |url=}}</ref><ref name="pmid29135819">{{cite journal |vauthors=Malec LM, Cooper J, Rudolph J, Michaels MG, Ragni MV |title=Prophylactic rtPA in the Prevention of Line-associated Thrombosis and Infection in Short Bowel Syndrome |journal=J. Pediatr. Gastroenterol. Nutr. |volume= |issue= |pages= |year=2017 |pmid=29135819 |doi=10.1097/MPG.0000000000001836 |url=}}</ref><ref name="pmid28937976">{{cite journal |vauthors=Martin LY, Ladd MR, Werts A, Sodhi CP, March JC, Hackam DJ |title=Tissue engineering for the treatment of short bowel syndrome in children |journal=Pediatr. Res. |volume= |issue= |pages= |year=2017 |pmid=28937976 |doi=10.1038/pr.2017.234 |url=}}</ref><ref name="pmid11873098">{{cite journal |vauthors=Sundaram A, Koutkia P, Apovian CM |title=Nutritional management of short bowel syndrome in adults |journal=J. Clin. Gastroenterol. |volume=34 |issue=3 |pages=207–20 |year=2002 |pmid=11873098 |doi= |url=}}</ref><ref name="pmid24500909">{{cite journal |vauthors=Tappenden KA |title=Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy |journal=JPEN J Parenter Enteral Nutr |volume=38 |issue=1 Suppl |pages=14S–22S |year=2014 |pmid=24500909 |doi=10.1177/0148607113520005 |url=}}</ref><ref name="pmid14642862">{{cite journal |vauthors=Vanderhoof JA, Young RJ |title=Enteral and parenteral nutrition in the care of patients with short-bowel syndrome |journal=Best Pract Res Clin Gastroenterol |volume=17 |issue=6 |pages=997–1015 |year=2003 |pmid=14642862 |doi= |url=}}</ref><ref name="pmid25052938">{{cite journal |vauthors=Bechtold ML, McClave SA, Palmer LB, Nguyen DL, Urben LM, Martindale RG, Hurt RT |title=The pharmacologic treatment of short bowel syndrome: new tricks and novel agents |journal=Curr Gastroenterol Rep |volume=16 |issue=7 |pages=392 |year=2014 |pmid=25052938 |doi=10.1007/s11894-014-0392-2 |url=}}</ref><ref name="pmid15233682">{{cite journal |vauthors=DiBaise JK, Young RJ, Vanderhoof JA |title=Intestinal rehabilitation and the short bowel syndrome: part 1 |journal=Am. J. Gastroenterol. |volume=99 |issue=7 |pages=1386–95 |year=2004 |pmid=15233682 |doi=10.1111/j.1572-0241.2004.30345.x |url=}}</ref><ref name="pmid15330926">{{cite journal |vauthors=DiBaise JK, Young RJ, Vanderhoof JA |title=Intestinal rehabilitation and the short bowel syndrome: part 2 |journal=Am. J. Gastroenterol. |volume=99 |issue=9 |pages=1823–32 |year=2004 |pmid=15330926 |doi=10.1111/j.1572-0241.2004.40836.x |url=}}</ref><ref name="pmid16770167">{{cite journal |vauthors=Matarese LE, Steiger E |title=Dietary and medical management of short bowel syndrome in adult patients |journal=J. Clin. Gastroenterol. |volume=40 Suppl 2 |issue= |pages=S85–93 |year=2006 |pmid=16770167 |doi=10.1097/01.mcg.0000212678.14172.7a |url=}}</ref><ref name="pmid24247092">{{cite journal |vauthors=Kelly DG, Tappenden KA, Winkler MF |title=Short bowel syndrome: highlights of patient management, quality of life, and survival |journal=JPEN J Parenter Enteral Nutr |volume=38 |issue=4 |pages=427–37 |year=2014 |pmid=24247092 |doi=10.1177/0148607113512678 |url=}}</ref>
===Appearance of the patient===
 
===Appearance of the Patient===
*Patients with short bowel syndrome usually appear weak and tired.  
*Patients with short bowel syndrome usually appear weak and tired.  


===Vital Signs===
===Vital signs===
*High-grade / low-grade [[fever]]
*Low-grade [[fever]]
*[[Hypothermia]] may be present
*[[Hypothermia]] may be present
*[[Tachycardia]] with regular pulse
*[[Tachycardia]] with regular pulse
Line 32: Line 31:
*Hyperactive [[bowel sound]]  
*Hyperactive [[bowel sound]]  
*[[Abdominal tenderness]]  
*[[Abdominal tenderness]]  
*[[Rebound tenderness]] (positive Blumberg sign)
*[[Rebound tenderness]] (positive [[Blumberg sign]])
*[[Abdominal guarding|Guarding]] may be present
*[[Abdominal guarding|Guarding]] may be present


===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
*Patient is usually oriented to person, place, and time
* [[Confusion]]
* [[Confusion]]
* [[Hyporeflexia]]
* [[Hyporeflexia]]
* [[Peripheral neuropathy]]
* [[Peripheral neuropathy]]
*Bilateral extremity weakness
*Bilateral extremity [[Muscle weakness|weakness]]


===Extremities===
===Extremities===
*Peripheral [[edema]]
*[[Peripheral edema]]
*[[Muscle atrophy]]
*[[Muscle atrophy|Muscular atrophy]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{WH}}
[[Category:Medicine]]
{{WS}}
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Up-To-Date]]

Latest revision as of 00:10, 30 July 2020

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

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]

Appearance of the patient

  • Patients with short bowel syndrome usually appear weak and tired.

Vital signs

Skin

HEENT

Abdomen

Neuromuscular

Extremities

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.