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afya
Abdo pain
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> ''Unusual'' myocardial infarction diabetic ketoacidosis pneumonia acute intermittent porphyria lead poisoning ''Peptic ulcer disease'' Duodenal ulcers: more common than gastric ulcers, epigastric pain relieved by eating Gastric ulcers: epigastric pain worsened by eating Features of upper gastrointestinal haemorrhage may be seen (haematemesis, melena etc) ''Appendicitis'' Pain initial in the central abdomen before localising to the right iliac fossa Anorexia is common Tachycardia, low-grade pyrexia, tenderness in RIF Rovsing's sign: more pain in RIF than LIF when palpating LIF ''Acute pancreatitis'' Usually due to alcohol or gallstones Severe epigastric pain Vomiting is common Examination may reveal tenderness, ileus and low-grade fever Periumbilical discolouration (Cullen's sign) and flank discolouration (Grey-Turner's sign) is described but rare ''Biliary colic'' Pain in the RUQ radiating to the back and interscapular region, may be following a fatty meal. Slight misnomer as the pain may persist for hours Obstructive jaundice may cause pale stools and dark urine It is sometimes taught that patients are female, forties, fat and fair although this is obviously a generalisation ''Acute cholecystitis'' History of gallstones symptoms (see above) Continuous RUQ pain Fever, raised inflammatory markers and white cells Murphy's sign positive (arrest of inspiration on palpation of the RUQ) ''Diverticulitis'' Colicky pain typically in the LLQ Fever, raised inflammatory markers and white cells ''Abdominal aortic aneurysm'' Severe central abdominal pain radiating to the back Presentation may be catastrophic (e.g. Sudden collapse) or sub-acute (persistent severe central abdominal pain with developing shock) Patients may have a history of cardiovascular disease ''Intestinal obstruction'' History of malignancy/previous operations Vomiting Not opened bowels recently 'Tinkling' bowel sounds
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Gastrointestinal