10 Questions
The differential diagnosis for abdominal pain can be classified as either acute or ____, based upon the length of time of the pain.
chronic
The four categories of the causes of acute abdominal pain are (1) inflammation, including appendicitis, cholecystitis, pancreatitis, and ____.
diverticulitis
The five categories of causes of chronic abdominal pain are (1) inflammation, including peptic ulcer disease, esophagitis, inflammatory bowel disease, and chronic ____.
pancreatitis
The second main symptom of gastrointestinal pathology is ____.
bleeding
The diagnosis of the source of an upper gastrointestinal bleed is often made by ______
endoscopy
Melena (i.e., black, tarry stool) is most often due to upper gastrointestinal ____.
bleeding
The differential diagnosis of lower gastrointestinal bleeding includes a rapid upper gastrointestinal bleed, diverticulosis, infections (e.g., Salmonella, Shigella), cancer, inflammatory bowel disease, and anal fissures or ______
hemorrhoids
Most diseases in the stomach are inflammatory (infectious) or ______
neoplastic
Inflammatory diseases (various forms of gastritis) may follow circulatory changes, autoimmune disorders, or infection (e.g., Helicobacter pylori ______)
gastritis
Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory ______
drugs
Study Notes
Differential Diagnosis of Abdominal Pain
- Abdominal pain can be classified as either acute or chronic, based on the duration of the pain.
- Four categories of causes of acute abdominal pain:
- Inflammation (e.g., appendicitis, cholecystitis, pancreatitis, diverticulitis)
- Perforation
- Obstruction
- Vascular disease (e.g., acute ischemia, ruptured abdominal aortic aneurysm)
- Five categories of causes of chronic abdominal pain:
- Inflammation (e.g., peptic ulcer disease, esophagitis, inflammatory bowel disease, chronic pancreatitis)
- Vascular disease (e.g., chronic ischemia)
- Metabolic disease (e.g., porphyria)
- Abdominal wall pain
- Functional causes (e.g., irritable bowel syndrome)
Symptoms of Gastrointestinal Bleeding
- Characteristics of blood can help identify the source of bleeding:
- Hematemesis (vomiting of bright red blood): proximal to the ligament of Treitz
- Melena (black, tarry stool): upper gastrointestinal bleeding
- Hematochezia (bright red blood per rectum): lower gastrointestinal bleeding or rapid upper gastrointestinal bleeding
- Differential diagnosis of upper gastrointestinal bleeding:
- Gastritis
- Esophageal varices
- Peptic ulcer disease
- Diagnosis of upper gastrointestinal bleeding is often made by endoscopy
- Differential diagnosis of lower gastrointestinal bleeding:
- Rapid upper gastrointestinal bleeding
- Diverticulosis
- Infections (e.g., Salmonella, Shigella)
- Cancer
- Inflammatory bowel disease
- Anal fissures or hemorrhoids
- Diagnosis of lower gastrointestinal bleeding is often determined by flexible sigmoidoscopy or colonoscopy
Gastritis
- Gastritis is an inflammatory disease that affects the stomach lining or mucosa
- Acute and chronic gastritis differ etiologically and morphologically
- Causes of gastritis:
- Infection (e.g., H. pylori)
- Chemical injury (e.g., aspirin, NSAIDs, alcohol, steroids)
- Autoimmunity
- Circulatory changes (e.g., stress, sepsis, shock)
- Characteristics of gastritis:
- Acute gastritis: commonly erosive, hemorrhagic, or both
- Chronic gastritis: ranges from mild, superficial to severe, atrophic with intestinal metaplasia and increased risk of gastric cancer
Symptoms of Gastritis
- Symptoms of gastritis vary among individuals, and many people have no symptoms
- Common symptoms include:
- Nausea or recurrent upset stomach
- Abdominal bloating
- Abdominal pain
- Vomiting
- Indigestion
- Burning or gnawing feeling in the stomach between meals or at night
- Hiccups
- Loss of appetite
- Vomiting blood
Test your knowledge on the differential diagnosis for abdominal pain, classified as acute or chronic. Learn about the four categories of causes of acute abdominal pain and the five categories of causes of chronic abdominal pain.
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