|
|
(29 intermediate revisions by 3 users not shown) |
Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| {{Tropical sprue}}
| | [[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Tropical_sprue]] |
| {{CMG}}; {{AE}} {{AKI}} | | {{CMG}};{{AE}}{{AKI}}{{Akshun}} |
|
| |
|
| ==Overview== | | ==Overview== |
| [[Tropical sprue]] should be differentiated from diseases causing chronic [[diarrhea]] and [[malabsorption]] such as [[celiac disease]], osmotic diarrhea and secretory diarrhea. | | [[Tropical sprue]] should be differentiated from diseases causing chronic [[diarrhea]] and [[malabsorption]] such as [[celiac disease]], [[Diarrhea|osmotic diarrhea]] and [[Diarrhea|secretory diarrhea]]. |
|
| |
|
| ==Differentiating Tropical Sprue from other Diseases== | | ==Differentiating Tropical Sprue from other Diseases== |
| [[Tropical sprue]] is a diagnosis of exclusion therefore it must be be differentiated from other diseases causing [[malabsorption]] such as: <ref name="pmid26628100">{{cite journal| author=Dosanjh G, Pardi DS| title=Chronic unexplained diarrhea: a logical and cost-effective approach to assessment. | journal=Curr Opin Gastroenterol | year= 2016 | volume= 32 | issue= 1 | pages= 55-60 | pmid=26628100 | doi=10.1097/MOG.0000000000000232 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26628100 }} </ref><ref name="pmid24889052">{{cite journal| author=Langenberg MC, Wismans PJ, van Genderen PJ| title=Distinguishing tropical sprue from celiac disease in returning travellers with chronic diarrhoea: a diagnostic challenge? | journal=Travel Med Infect Dis | year= 2014 | volume= 12 | issue= 4 | pages= 401-5 | pmid=24889052 | doi=10.1016/j.tmaid.2014.05.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24889052 }} </ref><ref name="pmid23073866">{{cite journal| author=Corinaldesi R, Stanghellini V, Barbara G, Tomassetti P, De Giorgio R| title=Clinical approach to diarrhea. | journal=Intern Emerg Med | year= 2012 | volume= 7 Suppl 3 | issue= | pages= S255-62 | pmid=23073866 | doi=10.1007/s11739-012-0827-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23073866 }} </ref><ref name="pmid22085666">{{cite journal| author=Juckett G, Trivedi R| title=Evaluation of chronic diarrhea. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 10 | pages= 1119-26 | pmid=22085666 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22085666 }} </ref> | | [[Tropical sprue]] is a diagnosis of exclusion therefore it must be be differentiated from other diseases causing [[malabsorption]] such as: <ref name="pmid26628100">{{cite journal| author=Dosanjh G, Pardi DS| title=Chronic unexplained diarrhea: a logical and cost-effective approach to assessment. | journal=Curr Opin Gastroenterol | year= 2016 | volume= 32 | issue= 1 | pages= 55-60 | pmid=26628100 | doi=10.1097/MOG.0000000000000232 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26628100 }} </ref><ref name="pmid24889052">{{cite journal| author=Langenberg MC, Wismans PJ, van Genderen PJ| title=Distinguishing tropical sprue from celiac disease in returning travellers with chronic diarrhoea: a diagnostic challenge? | journal=Travel Med Infect Dis | year= 2014 | volume= 12 | issue= 4 | pages= 401-5 | pmid=24889052 | doi=10.1016/j.tmaid.2014.05.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24889052 }} </ref><ref name="pmid23073866">{{cite journal| author=Corinaldesi R, Stanghellini V, Barbara G, Tomassetti P, De Giorgio R| title=Clinical approach to diarrhea. | journal=Intern Emerg Med | year= 2012 | volume= 7 Suppl 3 | issue= | pages= S255-62 | pmid=23073866 | doi=10.1007/s11739-012-0827-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23073866 }} </ref><ref name="pmid22085666">{{cite journal| author=Juckett G, Trivedi R| title=Evaluation of chronic diarrhea. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 10 | pages= 1119-26 | pmid=22085666 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22085666 }} </ref> |
| *Infectious causes | | *[[Infectious]] causes |
| *[[Celiac disease]] | | *[[Celiac disease]] |
| *[[Pancreatic insufficiency]] | | *[[Pancreatic insufficiency]] |
| *Osmotic diarrhea | | *[[Diarrhea|Osmotic diarrhea]] |
| *Secretory diarrhea | | *[[Diarrhea|Secretory diarrhea]] |
| ===Approach to a Patient with Chronic Diarrhea=== | | ===Approach to a Patient with Chronic Diarrhea=== |
| The following is an algorithm describing the approch to a patient with [[Chronic diarrhea resident survival guide|chronic diarrhea]]: | | The following is an algorithm describing the approch to a patient with [[Chronic diarrhea resident survival guide|chronic diarrhea]]: |
Line 59: |
Line 59: |
| {{familytree/end}} | | {{familytree/end}} |
|
| |
|
| Tropical sprue must be differentiated from other diseases that may cause [[chronic diarrhea]], [[weight loss]], and [[abdominal pain]] especially in [[Immunocompromised|immunocompromised patients]].
| | ===== Differentiating Tropical Sprue from Other causes of Fat Malabsorption ===== |
| {| style="border: 0px; font-size: 120%; margin: 3px; width:1000px;" align="center"
| | Tropical sprue must also be differentiated from other causes of fat malabsorption such as Whipple's disease, celiac disease, pancreatic disorders and other less common conditions. |
| | |
| |+
| |
| ! style="background: #4479BA; color:#FFF; width: 150px;" | Disease
| |
| ! style="background: #4479BA; color:#FFF; width: 200px;" | Prominent clinical findings
| |
| ! style="background: #4479BA; color:#FFF; width: 200px;" | Laboratory or radiological findings
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Giardiasis|Chronic giardiasis]]<ref name="pmid11113253">{{cite journal |vauthors=Thompson RC |title=Giardiasis as a re-emerging infectious disease and its zoonotic potential |journal=Int. J. Parasitol. |volume=30 |issue=12-13 |pages=1259–67 |year=2000 |pmid=11113253 |doi= |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * [[Giardiasis|Chronic giardiasis]] may develop after acute episode of giardiasis or without any acute events.
| |
| * Loose foul smelling stools
| |
| * [[Flatulence]]
| |
| * [[Fatigue]]
| |
| * [[Weight loss]]
| |
| * [[Steatorrhea]]
| |
| * Some patients develop acquired [[lactose intolerance]] (manifested by exacerbation of symptoms following ingestion of dairy products)
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * Microscopic identification of the organism in the stool
| |
| * [[Hypoalbuminaemia]]
| |
| * [[Vitamin B12]] and [[Folate deficiency|folate deficiencies]] (as the organism inhabits the [[duodenum]])
| |
| | |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Cryptosporidiosis]]<ref name="pmid17172373">{{cite journal |vauthors=Sánchez-Vega JT, Tay-Zavala J, Aguilar-Chiu A, Ruiz-Sánchez D, Malagón F, Rodríguez-Covarrubias JA, Ordóñez-Martínez J, Calderón-Romero L |title=Cryptosporidiosis and other intestinal protozoan infections in children less than one year of age in Mexico City |journal=Am. J. Trop. Med. Hyg. |volume=75 |issue=6 |pages=1095–8 |year=2006 |pmid=17172373 |doi= |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * [[Incubation period]] is 7-10 days.
| |
| * In [[immunocompetent]] patients:
| |
| :* Disease might be asymptomatic or cause [[gastroenteritis]] (but without any biliary involvement)
| |
| :* [[Gastroenteritis]] usually resolves spontaneously within 14 days.
| |
| * In [[immunocompromised]] patients:
| |
| :* Disease is usually more severe and prolonged (especially in severly [[Immunocompromised|immunocomprmised patients]] with [[CD4|CD4 count]] < 100 cells/microL).
| |
| :* [[Cryptosporidiosis]] may involve the [[biliary tract]] and the [[liver]].
| |
| :* [[Weight loss]]
| |
| :* [[RUQ|Abdominal RUQ]] [[tenderness]] might be present if [[biliary]] or [[hepatic]] involvement is present.
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * Microscopic identification of the [[organism]] in the stool: The [[oocysts]] appear red on staining with modified acid fast staining
| |
| * [[PCR]]: Most specific and sensitive diagnostic tool. [[PCR]] is expensive and used in limited cases.
| |
| | |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Cystoisospora belli|Cystoisosporiasis (isosporiasis)]]<ref name="pmid1889046">{{cite journal |vauthors=Current WL, Garcia LS |title=Cryptosporidiosis |journal=Clin. Microbiol. Rev. |volume=4 |issue=3 |pages=325–58 |year=1991 |pmid=1889046 |pmc=358202 |doi= |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * [[Cystoisospora belli|Cystoisosporiasis]] is usually seen in [[Immunocompromised|immunocompromised patients]].
| |
| * [[Incubation period]] can last up to 2 weeks
| |
| * [[Watery diarrhea]] that is profuse and foul smelling
| |
| * Constitutional symptoms ([[headache]], [[Low-grade fever|low grade fever]], [[myalgia]] and [[malaise]])
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * [[Isospora]] ova or parasites can be visualized on stool microscopic examination.
| |
| * [[Endoscopy|Upper GI endoscopy]] may used for excluding other esophageal or gastric disease and obtaining specimens for histopathology.
| |
| | |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Tropical sprue]]<ref name="pmid1091526">{{cite journal |vauthors=Klipstein FA, Schenk EA |title=Enterotoxigenic intestinal bacteria in tropical sprue. II. Effect of the bacteria and their enterotoxins on intestinal structure |journal=Gastroenterology |volume=68 |issue=4 Pt 1 |pages=642–55 |year=1975 |pmid=1091526 |doi= |url=}}</ref>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * History of travel to a tropical region (for a period more than a month)
| |
| * [[Chronic diarrhea]]
| |
| * [[Steatorrhea]]
| |
| * Examination may show signs of [[vitamin deficiencies]] (eg [[glossitis]])
| |
| | |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| * [[Megaloblastic anemia]] that might progress into [[pancytopenia]]
| |
| * [[Hypoalbuminaemia]]
| |
| * [[Vitamin D Deficiency|Vitamin D defeciency]] and [[hypocalcemia]]
| |
| | |
| |}
| |
|
| |
|
| <span style="font-size:85%">'''Abbreviations:''' | | <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, '''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> |
| | | <small> |
| {| align="center" | | {| align="center" |
| |- | | |- |
| | | | | |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" |
| ! colspan="3" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Classification of pain in the abdomen based on etiology
| |
| ! 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="12" 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 | | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| |- | | |- |
| | colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms''' | | | colspan="8" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms''' |
| ! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs | | ! 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" |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 |
Line 159: |
Line 93: |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging |
| |- | | |- |
| ! rowspan="55" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal causes
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tropical sprue]] |
| ! rowspan="40" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Inflammatory causes
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse |
| ! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pancreato-biliary disorders
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Acute suppurative cholangitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | 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" |<nowiki>+</nowiki> |
| | 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" |N | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| *Abnormal [[LFT]] | | * Fat soluble vitamin deficiency |
| *WBC >10,000 | | * [[Hypoalbuminemia]] |
| | * Fecal stool test |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Barium studies: |
| | * Dilation and edema of mucosal folds |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Ultrasound shows [[biliary]] dilatation/stents/tumor | | * [[Steatorrhea]]- 10-40 g/day (Normal=5 g/day) |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Septic shock occurs with features of [[SIRS]]
| |
| |- | | |- |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Cholangitis|Acute cholangitis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Whipple's disease]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[RUQ]] | | | 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" |<nowiki>+</nowiki> |
| | 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" |N | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Abnormal [[LFT]] | | * [[Thrombocytopenia]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | * [[Hypoalbuminemia]] |
| * Ultrasound shows [[biliary]] dilatation/stents/tumor | | * [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis. |
| * Biliary drainage ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) + IV antibiotics | | Images used to find complications |
| | *[[Whipple's disease x ray|Chest and joint x-ray]] |
| | *[[Whipple's disease CT|CT]] |
| | *[[Whipple's disease MRI|MRI]] |
| | *[[Whipple's disease ultrasound|Echocardiography]] |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings: |
| | * [[Uveitis]] |
| | * [[Endocarditis]] |
| | * [[Encephalitis]] |
| | * [[Dementia]] |
| | * [[Hepatosplenomegaly]] |
| | * [[Arthritis]] |
| | * [[Ascites]] |
| |- | | |- |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute cholecystitis|Acute cholecystitis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Celiac disease]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[RUQ]] | | | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | 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="center" | −
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Hyperbilirubinemia]] | | * [[IgA]] endomysial antibody |
| * [[Leukocytosis]] | | * [[IgA]] [[tissue transglutaminase]] antibody |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Ultrasound shows: | | * [[Anti-gliadin antibodies|Anti-gliadin antibody]] |
| * Gallstone | | * Small bowel biopsy |
| * Inflammation | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |US: |
| | * Bull’s eye or target pattern |
| | * Pseudokidney sign |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Murphy's sign|Murphy’s sign]] | | * Gluten allergy |
| |- | | |- |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute pancreatitis]] | | | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Acute pancreatitis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[Epigastric]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | [[Epigastric]] |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± |
Line 249: |
Line 191: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Pain radiation to back | | * Pain radiation to back |
| | |- |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever |
| | ! 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" |Constipation |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea |
| | ! 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" |Hypo- |
| | 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" |Bowel sounds |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging |
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| |- | | |- |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chronic pancreatitis]] | | | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chronic pancreatitis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] |
| | 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" | ± |
Line 277: |
Line 236: |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pancreatic carcinoma]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pancreatic carcinoma]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
Line 303: |
Line 261: |
| * [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]]) | | * [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]]) |
| * [[Panniculitis|Pancreatic panniculitis]] | | * [[Panniculitis|Pancreatic panniculitis]] |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary biliary cirrhosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]/[[Epigastric]]
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased AMA level, abnormal [[LFTs]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ERCP
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Pruritis
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Primary sclerosing cholangitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Increased liver enzymes
| |
| * Increased [[IgM]], [[IgG]]4
| |
| * [[Anti-neutrophil cytoplasmic antibody]] ([[p-ANCA]])
| |
| * [[Anti-nuclear antibody]] ([[ANA]])
| |
| * [[Anti-smooth muscle antibody]] (Anti-Sm)
| |
| * Anti-endothelial antibody
| |
| * Anti-cardiolipin antibody
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |ERCP and MRCP shows
| |
| * Multiple segmental [[strictures]]
| |
| * Mural irregularities
| |
| * [[Biliary]] dilatation and diverticula
| |
| * Distortion of biliary tree
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * The risk of [[cholangiocarcinoma]] in patients with primary sclerosing cholangitis is 400 times higher than the risk in the general population.
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cholelithiasis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]/[[Epigastric]]
| |
| | 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" |Normal to hyperactive for dislodged stone
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows [[gallstone]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Fatty food intolerance
| |
| |-
| |
| ! colspan="1" rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Gastric causes
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | [[Peptic Ulcer Disease|Peptic ulcer disease]]
| |
| | 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" | <nowiki>+</nowiki>
| |
| | 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" | <nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| |
| * Gastric ulcer- [[melena]] and [[hematemesis]]
| |
| * Duodenal ulcer- [[melena]] and [[hematochezia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if perforated
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ascitic fluid
| |
| ** [[LDH]] > serum [[LDH]]
| |
| ** Glucose < 50mg/dl
| |
| ** Total protein > 1g/dl
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Air under [[diaphragm]] in upright [[CXR]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Upper GI [[endoscopy]] for diagnosis
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastritis|Gastritis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | <nowiki>+</nowiki>
| |
| | 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" | Positive in chronic gastritis
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[H.pylori infection diagnostic tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Endoscopy]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[H.pylori gastritis guideline recommendation]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastroesophageal reflux disease|Gastroesophageal reflux disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Gastric emptying studies
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Esophageal]] [[manometry]]
| |
| * [[Endoscopy]] for alarm signs
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastric outlet obstruction|Gastric outlet obstruction]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | 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" | <nowiki>+</nowiki>
| |
| | 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" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Complete blood count]]
| |
| * [[Basic metabolic panel]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Abdominal x-ray]]- air fluid level
| |
| * Barium [[Upper GI series|upper GI studies]]- narrowed pylorus
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Succussion splash
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastroparesis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |Hyperactive/hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *[[Hemoglobin]]
| |
| *Fasting plasma glucose
| |
| *Serum total protein, albumin, [[thyrotropin]] ([[Thyroid-stimulating hormone|TSH]]), and an [[antinuclear antibody]] (ANA) titer
| |
| *[[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)
| |
| *Full thickness gastric and small intestinal biopsy
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gastrointestinal perforation]]
| |
| | 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" |<nowiki>-</nowiki>
| |
| | 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" |Hyperactive/hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * WBC> 10,000
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Air under [[diaphragm]] in upright [[CXR]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Hamman's sign]]
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Dumping syndrome]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Dumping syndrome]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Lower and then diffuse | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Lower and then 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
Line 575: |
Line 283: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Postgastrectomy | | * Postgastrectomy |
| |-
| |
| ! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Intestinal causes
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute appendicitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Starts in [[epigastrium]], migrates to RLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in pyogenic appendicitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" | Positive in perforated appendicitis
| |
| | 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" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ct scan
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Positive Rovsing sign
| |
| * Positive Obturator sign
| |
| * Positive Iliopsoas sign
| |
| |- | | |- |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diverticulitis|Acute diverticulitis]] | | | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diverticulitis|Acute diverticulitis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |LLQ | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |LLQ |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − |
Line 645: |
Line 308: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" | ± |
Line 665: |
Line 327: |
| * [[Uveitis]] | | * [[Uveitis]] |
| * [[Arthritis]] | | * [[Arthritis]] |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Irritable bowel syndrome]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Symptomatic treatment
| |
| * High [[dietary fiber]]
| |
|
| |
| * [[Osmotic]] [[laxatives]]
| |
| * [[Antispasmodic]] drugs
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Whipple's disease]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Thrombocytopenia]]
| |
| * [[Hypoalbuminemia]]
| |
| * [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis.
| |
| Images used to find complications
| |
| *[[Whipple's disease x ray|Chest and joint x-ray]]
| |
| *[[Whipple's disease CT|CT]]
| |
| *[[Whipple's disease MRI|MRI]]
| |
| *[[Whipple's disease ultrasound|Echocardiography]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
| |
| * [[Uveitis]]
| |
| * [[Endocarditis]]
| |
| * [[Encephalitis]]
| |
| * [[Dementia]]
| |
| * [[Hepatosplenomegaly]]
| |
| * [[Arthritis]]
| |
| * [[Ascites]]
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | | ! 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 |
Line 740: |
Line 346: |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic megacolon]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Irritable bowel syndrome]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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="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" | - |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Anemia]]
| |
| *[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]]
| |
| *[[Hypoalbuminemia]]
| |
| *[[Metabolic alkalosis]] associated with a poor [[prognosis]]
| |
| *[[Metabolic acidosis]] secondary to [[ischemic colitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT and [[Ultrasound]] shows:
| |
| *Loss of colonic haustration
| |
| *Hypoechoic and thickened bowel walls with irregular internal margins in the [[sigmoid]] and descending colon
| |
| *Prominent dilation of the transverse colon (>6 cm)
| |
| | |
| * Insignificant dilation of ileal bowel loops (diameter >18 mm) with increased intraluminal gas and fluid
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |- | |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tropical sprue]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" | − |
Line 782: |
Line 359: |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal |
| * Fat soluble vitamin deficiency
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal |
| * [[Hypoalbuminemia]]
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Symptomatic treatment |
| * Fecal stool test
| | * High [[dietary fiber]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Barium studies: | | |
| * Dilation and edema of mucosal folds
| | * [[Osmotic]] [[laxatives]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | * [[Antispasmodic]] drugs |
| * [[Steatorrhea]]- 10-40 g/day (Normal=5 g/day) | |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Celiac disease]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[IgA]] endomysial antibody
| |
| * [[IgA]] [[tissue transglutaminase]] antibody | |
| * [[Anti-gliadin antibodies|Anti-gliadin antibody]] | |
| * Small bowel biopsy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |US:
| |
| * Bull’s eye or target pattern
| |
| * Pseudokidney sign
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Gluten allergy
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infective colitis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infective colitis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" | − |
Line 838: |
Line 388: |
| * Edema | | * Edema |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Colon carcinoma]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Colon carcinoma]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse/ RLQ/LLQ | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse/ RLQ/LLQ |
| | 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" | − |
Line 884: |
Line 414: |
| * PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction | | * PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction |
| |- | | |- |
| ! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatic causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|Viral hepatitis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|Viral hepatitis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + |
Line 910: |
Line 438: |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
Line 930: |
Line 457: |
| * CT | | * CT |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatocellular carcinoma]]/[[Metastasis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |
| |
| * Normal
| |
| * Hyperactive if obstruction present
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * High levels of [[Alpha-fetoprotein|AFP]] in serum
| |
| * Abnormal [[Liver function test|liver function tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| * CT
| |
| * Liver biopsy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| Other symptoms:
| |
| * [[Splenomegaly]]
| |
| * [[Variceal bleeding]]
| |
| * [[Ascites]]
| |
| * [[Spider nevi]]
| |
| * [[Asterixis]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Budd-Chiari syndrome|Budd-Chiari syndrome]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | 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" | Positive in liver failure leading to varices
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *Elevated [[Aspartate aminotransferase|serum aspartate aminotransferase]] and [[alanine aminotransferase]] levels may be more than five times the upper limit of the normal range.
| |
| *Elevated serum [[alkaline phosphatase]] and [[Bilirubin|bilirubin levels]], decreased [[Albumin|serum albumin level]].
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Findings on [[CT scan]] suggestive of Budd-Chiari syndrome include:
| |
| *Early enhancement of the [[caudate lobe]] and [[central liver]] around the [[Inferior vena cavae|inferior vena cava]]
| |
| *Delayed enhancement of the peripheral [[liver]] with accompanying central low density (flip-flop appearance)
| |
| *Peripheral zones of the [[liver]] show reversed [[portal]] [[venous]] [[blood flow]]
| |
| *In the [[chronic]] phase, there is [[caudate lobe]] enlargement and [[atrophy]] of the [[Liver|peripheral liver]] in affected areas
| |
| |}
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Ascitic tap|Ascitic fluid examination]] shows:
| |
| *[[Total protein]] more than 2.5 g per deciliter
| |
| *[[White blood cells]] are usually less than 500/μL.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hemochromatosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | 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" | Positive in cirrhotic patients
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * >60% TS
| |
| * >240 μg/L SF
| |
| * Raised LFT <br>Hyperglycemia
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound shows evidence of cirrhosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
| |
| * Hyperpigmentation
| |
| * Diabetes mellitus
| |
| * Arthralgia
| |
| * Impotence in males
| |
| * Cardiomyopathy
| |
| * Atherosclerosis
| |
| * Hypopituitarism
| |
| * Hypothyroidism
| |
| * Extrahepatic cancer
| |
| * Prone to specific infections
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cirrhosis|Cirrhosis]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cirrhosis|Cirrhosis]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] |
| | 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" | − |
Line 1,070: |
Line 484: |
| * Cruveilhier- Baumgarten murmur | | * Cruveilhier- Baumgarten murmur |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | | |} |
| | |} |
| | </small> |
| | ===== Differentiating Tropical Sprue from Other causes of Fat Malabsorption in Immunocompromised Patients ===== |
| | Tropical sprue must be differentiated from other diseases that may cause [[chronic diarrhea]], [[weight loss]], and [[abdominal pain]] especially in [[Immunocompromised|immunocompromised patients]]. These conditions include chronic giardiasis, cryptosporidiosis, [[Cystoisospora belli|Cystoisosporiasis (isosporiasis)]]<ref name="pmid1889046">{{cite journal |vauthors=Current WL, Garcia LS |title=Cryptosporidiosis |journal=Clin. Microbiol. Rev. |volume=4 |issue=3 |pages=325–58 |year=1991 |pmid=1889046 |pmc=358202 |doi= |url=}}</ref><ref name="pmid11113253">{{cite journal |vauthors=Thompson RC |title=Giardiasis as a re-emerging infectious disease and its zoonotic potential |journal=Int. J. Parasitol. |volume=30 |issue=12-13 |pages=1259–67 |year=2000 |pmid=11113253 |doi= |url=}}</ref><ref name="pmid17172373">{{cite journal |vauthors=Sánchez-Vega JT, Tay-Zavala J, Aguilar-Chiu A, Ruiz-Sánchez D, Malagón F, Rodríguez-Covarrubias JA, Ordóñez-Martínez J, Calderón-Romero L |title=Cryptosporidiosis and other intestinal protozoan infections in children less than one year of age in Mexico City |journal=Am. J. Trop. Med. Hyg. |volume=75 |issue=6 |pages=1095–8 |year=2006 |pmid=17172373 |doi= |url=}}</ref><ref name="pmid1091526">{{cite journal |vauthors=Klipstein FA, Schenk EA |title=Enterotoxigenic intestinal bacteria in tropical sprue. II. Effect of the bacteria and their enterotoxins on intestinal structure |journal=Gastroenterology |volume=68 |issue=4 Pt 1 |pages=642–55 |year=1975 |pmid=1091526 |doi= |url=}}</ref> |
| | <small> |
| | {| align="center" |
| | |- |
| | | |
| | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" |
| | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease |
| | | colspan="12" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations''' |
| | ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis |
| | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments |
| | |- |
| | | colspan="8" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''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" |Abdominal Pain |
| ! 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 |
Line 1,082: |
Line 512: |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- |
| tension | | tension |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding | | ! 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" |Bowel sounds |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings | | ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |- | | |- |
| ! rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Peritoneal causes
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tropical sprue]] |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Spontaneous bacterial peritonitis]] | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" | Positive in cirrhotic patients
| | | 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" |
| |
| * Ascitic fluid [[PMN]]>250 cells/mm<small>³</small>
| |
| * Culture: Positive for single organism
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound for evaluation of liver cirrhosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Renal causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pyelonephritis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Unilateral
| |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | 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" |N |
| | 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" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Urinalysis | | * Fat soluble vitamin deficiency |
| * Urine culture | | * [[Hypoalbuminemia]] |
| * Blood culture | | * Fecal stool test |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Barium studies: |
| | * Dilation and edema of mucosal folds |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * CT | | * [[Steatorrhea]]- 10-40 g/day (Normal=5 g/day) |
| * MRI
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *CVA tenderness
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Renal colic]] | | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Giardiasis |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Flank pain]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Hematuria]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| * CT scan
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Colicky [[abdominal pain]]
| |
| * [[Dysuria]]
| |
| |-
| |
| ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Hollow Viscous Obstruction
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Small bowel obstruction]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | | | 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" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |Hyperactive then absent
| |
| | 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]]
| |
| * Dilated loops of 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
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Volvulus]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" | Positive in perforated cases
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive then absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan and [[Abdominal x-ray|abdominal X ray]]
| |
| * U shaped sigmoid colon
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * "Whirl sign"
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Biliary colic]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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="center" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * ↑ [[bilirubin]] and [[alkaline phosphatase]] | | * [[Hypoalbuminaemia]] |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | * [[Vitamin B12]] and [[Folate deficiency|folate deficiencies]] (as the organism inhabits the [[duodenum]]) |
| * Ultrasound | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |EGD with small bowel tissue biopsy |
| | * Reserved for patients with high suspicion of giardiasis and undiagnosed by other methods |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | * Microscopic identification of the organism in the stool |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cryptosporiadisis |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Vascular Disorders
| |
| ! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Ischemic causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mesenteric ischemia]] | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Periumbilical
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if bowel becomes gangrenous
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive to absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]] and [[lactic acidosis]]
| |
| * [[Amylase]] levels
| |
| * [[D-dimer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT angiography
| |
| * SMA or SMV thrombosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Also known as abdominal angina that worsens with eating
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ischemic colitis|Acute ischemic colitis]]
| |
| | 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" |<nowiki>+</nowiki> | |
| | 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" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive then absent | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> |
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * [[Leukocytosis]] | | * [[PCR]]: Most specific and sensitive diagnostic tool. [[PCR]] is expensive and used in limited cases. |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal x-ray]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal |
| * Distension and pneumatosis
| |
| CT scan
| |
| * Double halo appearance, thumbprinting
| |
| * Thickening of bowel
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * May lead to shock | | * Stool examination: [[Oocysts]] appear red on staining with modified acid fast staining |
| |- | | |- |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hemorrhagic causes
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystoisospora belli|Cystoisosporiasis (isosporiasis)]] |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ruptured abdominal aortic aneurysm]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Fibrinogen]]
| |
| * [[D-dimer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Focused Assessment with Sonography in Trauma (FAST)
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Unstable hemodynamics
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Intra-abdominal or [[retroperitoneal hemorrhage]]
| |
| | 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="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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ↓ Hb
| |
| * ↓ Hct
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CT scan
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * History of [[trauma]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! 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" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! 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" |Hypo-
| |
| 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" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Gynaecological Causes
| |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Tubal causes
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Torsion of the cyst/ovary
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ↑ [[ESR]]
| |
| * ↑ [[CRP]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Sudden onset & severe pain
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Salpingitis|Acute salpingitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | 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="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Pelvic ultrasound]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Vaginal discharge]]
| |
| |- | |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cyst rupture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |N
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ↑ [[ESR]]
| |
| * ↑ [[CRP]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |- | |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pregnancy
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Ruptured [[ectopic pregnancy]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RLQ / LLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Positive [[pregnancy test]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of
| |
| * Missed period
| |
| * Vaginal bleeding
| |
| |-
| |
| ! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra-abdominal causes
| |
| ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pulmonary disorders
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pleural empyema]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]/[[Epigastric]]
| |
| | 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" |<nowiki>+</nowiki>
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Thoracentesis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Chest X-ray]]
| |
| * Pleural opacity
| |
| | |
| * Localization of effusion
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Physical examination | |
| * Crackles
| |
| * [[Egophony]]
| |
| * Increased [[tactile fremitus]]
| |
| |-
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary embolism]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ/LUQ
| |
| | 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" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ABGs
| |
| * D-dimer
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * CXR | | * Peripheral eosinophilia |
| * V/Q scan | | * Stool test is positive for immature oocyst that contains a spherical mass of [[protoplasm]] |
| * Spiral [[CT pulmonary angiogram]]
| | | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Upper GI series depicts minimal or irregular thickening of mucosal folds |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Dyspnea | | * AIDS defining condition |
| * Tachycardia
| |
| * Pleuretic chest pain
| |
| |-
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ/LUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" |Normal or hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * ABGs
| |
| * Leukocytosis
| |
| * Pancytopenia
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| *CXR
| |
| *CT chest
| |
| *Bronchoscopy
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Shortness of breath
| |
| * Cough
| |
| |-
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cardiovascular disorders
| |
| | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial Infarction]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | 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" | Positive in cardiogenic shock
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Cardiac enzymes]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[ECG]]
| |
| [[Echocardiogram]]
| |
| * Wall motion abnormality
| |
| * Wall rupture
| |
| * Septal rupture
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Chest pain, tightness, diaphoresis
| |
| Complications:
| |
| * [[Arrythmias]]
| |
| * [[Mitral regurgitation]]
| |
| * Ventricular wall rupture
| |
| * Septal rupture
| |
| |-
| |
| |} | | |} |
| |} | | |} |
| | </small> |
|
| |
|
| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| [[Category:Emergency mdicine]]
| | |
| | [[Category:Emergency mdicine]] |
| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Primary care]]
| |
| [[Category:Up-To-Date]] | | [[Category:Up-To-Date]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |
| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |