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Abdominal Distension (Flatus (Bowel Dilation) PE: tympanic on percussion…

- - - - Myopathic
        
        Scleroderma
        
        Familial
      - Neuropathic
        
        Enteric (DM, amyloid, paraneoplastic, narcotics)
        
        Extrinsic (MS, spinal injury stroke)
    - - Toxic Megacolon
        Oglivie's syndrome
        Trauma, Drug, Surgery
        Retroperitoneal hemorrhage
        Malignancy
- - - - Jaundiced
        
        Stigmata of CLD:
        
        Cirrhosis
        
        Chronic Obstruction
        
        No Stigmata of CLD:
        
        Hepatitis
        
        Hemolytic anemia
      - Not Jaundiced
        
        Non-Cardiac:
        
        Hepatomegaly (neoplasm/fatty liver)
        
        Spenomegaly (hematological, infection of virus)
        
        Cardiac: Heart Failure/ JVP increase
        
        Right heart failure
        
        Tricuspid regurgitation
    - - Bilateral: Autosomal dominant polcystic/obstruction
      - Unilateral: Neoplastic/obstruction +- infection
    - - GI:
        
        Colorectal cancer (PR bleed/bowel habit change
        
        Abscess - diverticular/appendicular (infections)
      - Urological: Palpable bladder
- - - - Peritoneal infection
      - Pancreatic disease
      - Peritoneal carcinomatosis
        
        primary peritoneal malignancies - mesothelioma/sarcoma
        
        abdominal malignancies - gastric/colonic adenocaricnoma
        
        metastatic disease from breast/lung carcinoma or melanoma
    - - Chronic liver disease (Cirrhosis - 84% of ascites)
        
        Pathophysiology: portal hypertension (umbilical venous hum) & salt and water retention
        
        Hx: Alcohol use
        
        PE: jaundice, spider angiomas, palmar erythema, caput medusae, gynecomastia
        
        Complication: if present with altered mental state also think about meningitis
      - Hepatic (alcoholic/liver failure/cancer
      - Cardiovascular causes:
        
        Rt. Heart failure / Veno-occlusive dx (sinusoids)/ IVC Obstruction
        
        Hepatic vein obs (buddchain): thrombosis, CA
        
        PE: JVP, Kussmaul's sign (elevation of JVP upon inspiration), pericardial knock, tricuspid regurgitation's murmur), detect pulsation upon light palpation of liver upon