Disease
|
Clinical manifestations
|
Diagnosis
|
Comments
|
Symptoms
|
Signs
|
Abdominal Pain
|
Fever
|
Rigors and chills
|
Nausea or vomiting
|
Jaundice
|
Constipation
|
Diarrhea
|
Weight loss
|
GI bleeding
|
Hypo-
tension
|
Guarding
|
Rebound Tenderness
|
Bowel sounds
|
Lab Findings
|
Imaging
|
Chronic pancreatitis
|
Epigastric
|
−
|
−
|
±
|
±
|
−
|
+
|
+
|
−
|
−
|
−
|
−
|
N
|
- Increased amylase / lipase
- Increased stool fat content
- Pancreatic function test
|
CT scan
- Calcification
- Pseudocyst
- Dilation of main pancreatic duct
|
- Predisposes to pancreatic cancer
|
Pancreatic carcinoma
|
Epigastric
|
−
|
−
|
+
|
+
|
−
|
+
|
+
|
−
|
−
|
−
|
−
|
N
|
|
|
Skin manifestations may include:
|
Peptic ulcer disease
|
Diffuse
|
±
|
−
|
+
|
−
|
−
|
−
|
+
|
|
Positive if perforated
|
Positive if perforated
|
Positive if perforated
|
N
|
- Ascitic fluid
- LDH > serum LDH
- Glucose < 50mg/dl
- Total protein > 1g/dl
|
|
|
Disease
|
Abdominal Pain
|
Fever
|
Rigors and chills
|
Nausea or vomiting
|
Jaundice
|
Constipation
|
Diarrhea
|
Weight loss
|
GI bleeding
|
Hypo-
tension
|
Guarding
|
Rebound Tenderness
|
Bowel sounds
|
Lab Findings
|
Imaging
|
Comments
|
Gastritis
|
Epigastric
|
±
|
−
|
+
|
−
|
−
|
−
|
Positive in chronic gastritis
|
+
|
−
|
−
|
−
|
N
|
|
|
|
Gastric outlet obstruction
|
Epigastric
|
−
|
−
|
±
|
−
|
−
|
−
|
+
|
−
|
−
|
−
|
−
|
Hyperactive
|
|
|
|
Gastroparesis
|
Epigastric
|
−
|
−
|
+
|
−
|
−
|
−
|
+
|
−
|
±
|
−
|
−
|
Hyperactive/hypoactive
|
- Hemoglobin
- Fasting plasma glucose
- Serum total protein, albumin, thyrotropin (TSH), and an antinuclear antibody (ANA) titer
- HbA1c
|
- Scintigraphic gastric emptying
|
- Succussion splash
- Single photon emission computed tomography (SPECT)
- Full thickness gastric and small intestinal biopsy
|
Dumping syndrome
|
Lower and then diffuse
|
−
|
−
|
+
|
−
|
−
|
+
|
+
|
−
|
+
|
−
|
−
|
Hyperactive
|
- Glucose challenge test
- Hydrogen breath test
|
- Upper GI series
- Gastric emptying study
|
|
Disease
|
Abdominal Pain
|
Fever
|
Rigors and chills
|
Nausea or vomiting
|
Jaundice
|
Constipation
|
Diarrhea
|
Weight loss
|
GI bleeding
|
Hypo-
tension
|
Guarding
|
Rebound Tenderness
|
Bowel sounds
|
Lab Findings
|
Imaging
|
Comments
|
Inflammatory bowel disease
|
Diffuse
|
±
|
−
|
−
|
±
|
−
|
+
|
+
|
+
|
−
|
−
|
−
|
Normal or hyperactive
|
|
|
Extra intestinal findings:
|
Irritable bowel syndrome
|
Diffuse
|
−
|
−
|
−
|
−
|
±
|
±
|
+
|
−
|
−
|
−
|
−
|
N
|
Normal
|
Normal
|
Symptomatic treatment
|
Whipple's disease
|
Diffuse
|
±
|
−
|
−
|
±
|
−
|
+
|
+
|
−
|
±
|
−
|
−
|
N
|
|
Endoscopy is used to confirm diagnosis.
Images used to find complications
|
Extra intestinal findings:
|
Disease
|
Abdominal Pain
|
Fever
|
Rigors and chills
|
Nausea or vomiting
|
Jaundice
|
Constipation
|
Diarrhea
|
Weight loss
|
GI bleeding
|
Hypo-
tension
|
Guarding
|
Rebound Tenderness
|
Bowel sounds
|
Lab Findings
|
Imaging
|
Comments
|
Tropical sprue
|
Diffuse
|
+
|
−
|
−
|
−
|
−
|
+
|
+
|
−
|
−
|
−
|
−
|
N
|
|
Barium studies:
- Dilation and edema of mucosal folds
|
|
Celiac disease
|
Diffuse
|
−
|
−
|
−
|
−
|
−
|
+
|
+
|
−
|
−
|
−
|
−
|
Hyperactive
|
|
US:
- Bull’s eye or target pattern
- Pseudokidney sign
|
|
Colon carcinoma
|
Diffuse/localized
|
−
|
−
|
−
|
−
|
±
|
±
|
+
|
+
|
±
|
−
|
−
|
- Normal or hyperactive if obstruction present
|
- CBC
- Carcinoembryonic antigen (CEA)
|
- Colonoscopy
- Flexible sigmoidoscopy
- Barium enema
- CT colonography
|
- PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction
|
Viral hepatitis
|
RUQ
|
+
|
−
|
+
|
+
|
−
|
Positive in Hep A and E
|
+
|
−
|
Positive in fulminant hepatitis
|
Positive in acute
|
+
|
N
|
- Abnormal LFTs
- Viral serology
|
|
- Hep A and E have fecal-oral route of transmission
- Hep B and C transmits via blood transfusion and sexual contact.
|
Liver abscess
|
RUQ
|
+
|
+
|
+
|
+
|
−
|
±
|
+
|
−
|
+
|
+
|
±
|
Normal or hypoactive
|
|
|
|
Hepatocellular carcinoma/Metastasis
|
RUQ
|
+
|
−
|
−
|
+
|
−
|
−
|
+
|
−
|
−
|
−
|
−
|
- Normal
- Hyperactive if obstruction present
|
|
|
Other symptoms:
|
Disease
|
Abdominal Pain
|
Fever
|
Rigors and chills
|
Nausea or vomiting
|
Jaundice
|
Constipation
|
Diarrhea
|
Weight loss
|
GI bleeding
|
Hypo-
tension
|
Guarding
|
Rebound Tenderness
|
Bowel sounds
|
Lab Findings
|
Imaging
|
Comments
|
Cirrhosis
|
RUQ
|
−
|
−
|
−
|
+
|
−
|
−
|
+
|
+
|
+
|
−
|
−
|
N
|
|
US
|
- Stigmata of liver disease
- Cruveilhier- Baumgarten murmur
|
Small bowel obstruction
|
Diffuse
|
+
|
−
|
+
|
−
|
+
|
−
|
+
|
−
|
+
|
+
|
±
|
Hyperactive then absent
|
|
Abdominal X ray
- Dilated loops of bowel with air fluid levels
- Gasless abdomen
|
- "Target sign"– , indicative of intussusception
- Venous cut-off sign" – suggests thrombosis
|
Mesenteric ischemia
|
Periumbilical
|
Positive if bowel becomes gangrenous
|
−
|
+
|
−
|
−
|
+
|
+
|
+
|
Positive if bowel becomes gangrenous
|
Positive if bowel becomes gangrenous
|
−
|
Hyperactive to absent
|
|
CT angiography
|
- Also known as abdominal angina that worsens with eating
|
Acute ischemic colitis
|
Diffuse
|
+
|
±
|
+
|
−
|
−
|
+
|
+
|
+
|
+
|
+
|
+
|
Hyperactive then absent
|
|
Abdominal x-ray
- Distension and pneumatosis
CT scan
- Double halo appearance, thumbprinting
- Thickening of bowel
|
|
Ruptured abdominal aortic aneurysm
|
Diffuse
|
±
|
−
|
+
|
−
|
−
|
−
|
+
|
+
|
+
|
−
|
−
|
N
|
|
- Focused Assessment with Sonography in Trauma (FAST)
|
|
Pleural empyema
|
RUQ/Epigastric
|
+
|
±
|
−
|
−
|
−
|
−
|
+
|
−
|
−
|
−
|
−
|
N
|
|
Chest X-ray
|
Physical examination
|