Abdomen Conditions PDF

**McBurney\'s Point:** - A spot on your lower right abdomen used to locate the appendix. - It\'s about **1/3 of the way** between the **belly button (umbilicus)** and the **front of your hip bone (anterior superior iliac crest)**. **Abdomen Conditions** **Peritonitis:** - Inflamma...

**McBurney\'s Point:** - A spot on your lower right abdomen used to locate the appendix. - It\'s about **1/3 of the way** between the **belly button (umbilicus)** and the **front of your hip bone (anterior superior iliac crest)**. **Abdomen Conditions** **Peritonitis:** - Inflammation of the peritoneum (lining of the abdominal cavity). - - **Cholecystitis:** - Inflammation of the gallbladder. - **Severe pain on the right side of the abdomen, just below the ribs.** **Appendicitis:** - Inflammation of the appendix, a common cause of abdominal pain. - Pain often starts near the belly button and moves to McBurney\'s point. - Can be confused with **cholecystitis** (inflammation of the gallbladder), which causes pain in the upper right abdomen. **Dyspepsia**: Feeling of **upset stomach** or **indigestion** (bloating, discomfort, or burping). **Constipation**: Having **less than 3 bowel movements per week**, often with difficulty. **Gastritis**: **Inflammation of the stomach** lining, causing **nausea** and/or **pain**. **Peptic Ulcer Disease**: - **Sores** in the stomach or duodenum. - Common causes: - **H. pylori infection** (bacteria). - Long-term use of **anti-inflammatory medications** like ibuprofen. **Diverticuli:** - Small pouches that form in the wall of the intestine (usually the colon). - **Normal**: These pouches are harmless and not inflamed. **Diverticulitis:** - When these pouches get i**nflamed or infected**, it's called diverticulitis. - Symptoms: Abdominal pain, fever, and changes in bowel habits. **Diverticulosis**: A condition where you **have diverticuli**, but they are **not inflamed**. **Intestinal obstructions ileus** - Not a surgical but a medical emergency **Intestinal obstruction ** - due to intestine strangulation = surgical emergency **Hepatitis**: - **What is it?** Inflammation of the liver. - **Causes**: Viral infections, alcohol, drugs, or immune system problems. **Cirrhosis**: - **What is it?** Scarring of the liver due to long-term inflammation. - **Causes**: Heavy drinking or chronic hepatitis. **Ascites**: - **What is it?** Fluid buildup in the abdomen. - **Cause**: Commonly caused by **cirrhosis**. **Abdominal Hernia**: - **What is it?** A gap or weakness in the abdominal wall that allows part of the intestine to stick out. **Abdominal Distension**: - **What is it?** Swelling of the abdomen due to increased pressure or size. - **Causes**: Often related to conditions like **IBS (Irritable Bowel Syndrome)** or gas buildup. - **Symptoms**: Belly looks or feels larger than normal. **Abdominal Aortic Aneurysm (AAA)**: - **What is it?** A weak spot in the **aorta** (the large blood vessel in the abdomen) causes it to bulge like a balloon. - **Risks**: Over time, the bulge can get bigger and might **burst**, which is life-threatening. **Swishing/Burring Sound**: - **Medium to large aneurysm** (bulging of the blood vessel wall) in the **descending aorta**. - More common in the **descending aorta** than the ascending. **Epigastric Pain:** Pain felt in the upper middle abdomen (just below the ribs). - **Possible Causes**: 1. **Cardiac issues**: - **Heart attack** or **angina** can sometimes feel like epigastric pain. 2. **GERD (Gastroesophageal Reflux Disease)**: - Acid reflux causing a burning sensation in the epigastric area. 3. **IBS (Irritable Bowel Syndrome)**: - Abdominal discomfort caused by gut sensitivity. 4. **Hepatitis**: - Liver inflammation can lead to discomfort or pain in the upper abdomen. **Common/Concerning Symptoms** 1. **Abdominal pain** 2. **Indigestion, nausea, vomiting, loss of appetite** 3. **Dysphagia** 4. **Diarrhea, constipation** - - - 5. **Jaundice** - 1. **Ulcerative Colitis**: - A **hereditary autoimmune disease**. - Affects only the **colon (large intestine)**. - Causes inflammation, ulcers, and symptoms like diarrhea, abdominal pain, and blood in stool. 2. **Crohn's Disease**: - Also an **autoimmune disease**, but not limited to the colon. - Can affect **any part of the gastrointestinal (GI) tract** (from the mouth to the anus). - Causes patchy inflammation, leading to abdominal pain, diarrhea, and malnutrition. 3. **Pseudo-Ulcerative Colitis**: → **C-diff** - Mimics ulcerative colitis but is caused by **antibiotic abuse**. - Not autoimmune or hereditary. - Can lead to symptoms similar to ulcerative colitis but stems from an imbalance in gut bacteria. **Color of Stool** **Melena**: - **What is it?** Black, tarry stools caused by **digested blood**. - **Cause**: Bleeding from the **upper GI tract** (e.g., stomach or small intestine). - **Key Point**: Bleeding is **not excessive** but has time to be digested as it travels through the GI tract. **Hematochezia**: - **What is it?** Bright red or maroon blood in stools. - **Cause**: Bleeding from the **lower GI tract** (e.g., colon, rectum, or anus). - **Examples**: - **Inflammatory bowel disease (IBD)** (e.g., ulcerative colitis or Crohn's disease). - **Hemorrhoids** (swollen veins in the anus). - **Arteriovenous malformation** (abnormal blood vessels). - **Key Point**: Often indicates **excessive bleeding**, and blood is fresh. **Varices**: - Small, **distended veins** in the lining of the GI tract (often in the esophagus or stomach). - Can rupture and cause **severe bleeding**, leading to melena. **Esophageal varices are caused by portal hypertension and portal hypertension leads to liver cirrhosis** **Hyperbilirubinemia** - When the liver cannot process bilirubin (a waste product from breaking down red blood cells). **Can lead to:** - **Icterus/Jaundice:** Yellowing of the skin and eyes. - **Bilirubinuria:** Bilirubin appears in urine, making it dark-colored. **Bilirubinemia ** - urine manifests in conjugated or mixed hyperbilirubinemia, whereas normal urine is seen in unconjugated disease. - causes **Coca-Cola urine** **Assessment**  - patients with liver disease, don't give Tylenol/acetaminophen - patients with kidney disease do not prescribe NSAIDs can aggravate the condition **Liver Vasculature** - **Portal Vein: Brings nutrient-rich blood from the GI tract.** - Only hypertension that can be caused by venous vasculature is the **portal hypertension** - - All other hypertension is caused by diseases of the atrial source because arteries are surrounded by smooth muscle which allows them to contract  and control blood flow. - **Portal Hypertension** - Causes **splenomegaly** because of backflow of blood into the spleen - **Splenomegaly** = decreased WBC count and increased tendency to infection, leads to thrombocytopenia, can still do oral procedure without the risk of bleeding **4 Things Portal Hypertension can lead to** - Esophageal varices - Caput medusae - Ascites  - Splenomegaly  **Excessive liver cirrhosis** = reduced vitamin K, so this will impact clotting and may lead to excessive bleeding **Caput medusae ** - Refers to **swollen veins** around the belly button that look like a network of radiating lines. - **Portal Hypertension** (high blood pressure in the portal vein system, often from liver disease like cirrhosis) causes blood to back up. - This backup forces blood to flow through smaller veins, like those around the belly button, making them swell. https://lh7-rt.googleusercontent.com/docsz/AD\_4nXegWwWWrlNRoXa-hRam1TMqiC9b3\_9wEEM9sX9posEEicjkGcEhO8bH\_jno7QlRCtvLHaE8dNMTEK00rHDR2lncNRbRn0YBL-zkGh698W0YP\_vQusPTtJATiqxkbYtDWOalHx8uOg?key=z9Im0Zctsn8MzQ-1cOYviHKO **Increased Systemic Estrogen Levels:** - The liver normally removes extra estrogen, but if it's not working, estrogen levels rise. - **Effects**: - **Gynecomastia**: Breast tissue development in men. - **Spider Angiomata**: Small red spider-like blood vessel clusters on the skin. - **Palmar Erythema**: Redness of the palms. - **Testicular Atrophy**: Shrinking of the testes. **Pitting Edema:** - Swelling in the legs where pressing on the skin leaves a dent. - It\'s a sign of fluid imbalance, often linked to heart, liver, kidney, or blood flow problems. **Differential diagnosis** - - - - - **Hepatorenal syndrome:**  both kidney and liver disease with unknown origin **Renal and hepatic advanced diseases:** Both can cause encephalopathy - **Asterixis**, flapping tremor, sign of encephalopathy **Other symptoms of liver diseases ** **Leukonychia**- white color of the nails due to hypoalbuminemia **Koilonychia**- due to iron deficiency anemia **Nails-** clubbing, loss of schamroth's window **Hepatic disease ** - **Dupetryen's contracture** - liver cirrhosis - Spider angiomas/nevi- chest face and neck - Palmar erythema - c chronic liver disease **Rovsing\'s Sign:** 1. **What is it?** - A test to check for **appendicitis**. 2. **How it's done**: - The patient lies on their back (**supine position**). - The doctor presses on the **lower left abdomen** and quickly releases. 3. **What happens?** - Pressing on the left side **pushes fluids and gas** toward the inflamed appendix on the **right side**. - This causes **pain in the lower right abdomen**. 4. **What does it mean?** - **Positive Rovsing\'s Sign**: Pain in the right lower abdomen when pressing the left side suggests **appendicitis**. **What is GFR?** - A test to measure how well your **kidneys filter blood**. - It shows how much blood passes through the kidney filters (glomeruli) each minute. **Normal Ranges**: - **Men**: 100--130 mL/min/1.73m². - **Women**: 90--120 mL/min/1.73m². **Key Points**: - **\>90 mL/min**: Normal kidney function. - **\