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Abdominal Distention (Fluid (Portal Hypertension (Liver cirrhosis (:check:…
Abdominal Distention
Fluid
Ascites
:check: abdominal discomfort, weight gain, early satiety, dyspnea, SOB
:silhouette: flank dullness, shifting dullness, fluid wave, pleural effusions
Pseudocyst
Portal Hypertension
Liver cirrhosis
:check: heavy alcohol use, infection history, metabolic diseases
:silhouette: spider nevi, palmar erythema, hsmegaly, caput medusae
Alcoholic Hepatitis
:check: febrile, heavy alcohol use
:silhouette: hsmegaly, jaundice, epigastric pain, proximal muscle weakness
Acute liver Failure
:check: encepalopathy (confusion), anorexia, N/V, pruritus
:silhouette: hepatomegaly, RUQ pain, asterixis,jaundice
Right HEart Failure
:silhouette: peripheral edema, distended JVP, pulmonary congestion
:check: dyspnea, orthpnea
Constrictive Pericarditis
:check: fatigue, dyspnea
:silhouette: elevated JVP, pericardial kncok
Budd-Chiari
:check: upper abdo pain, encephalopathy, acute weakness, thrombosis
:silhouette: hsmegaly, RUQ pain, jaunrice
Peritoneal disease
infectious
:check: fever, N/V, altered mental status, diarrhea, SBP, TB, advanced sirrhosis
:silhouette: abdominal tenderness, altered mental status, diffused abdo pain
renal failure
:check: malaise, confusion, N/V, Dm/HTN
:silhouette: renal punch, flank pain, ballotable kidney
Faecal
Mechanical Small Bowel Obstruction
:check: pain with abrupt onset, N/V, PMH, obstiaption
:warning: PMH: anticholinergic, cation-containing, analgesics, neural-active
IBS
:check: stomach pain, post prandial cramps, diarrhea, constipation, bloating, flatulence
:silhouette: overall healthy with tensing, sigmoid tenderness or palpable sigmoid cord
Constipation
:check: infrequent stools, fecal impaction and incontinence, difficult in passing bowels
:silhouette: Rectal exam may be useful, otherwise uneventful
Fatal
Aorticaneurysm
:silhouette: pulsatile expansile mass in epigastric and upper umbilical region
malignancy
:silhouette: virchow's nodes, nodular liver
:check: weight loss, early satiety
:silhouette: for liver cancer, hsmegaly, lymphadenopathy, RUQ pain, jaundice
abscess
:check: fever, infection, DM, underlying organ damage/disease
Fat
Hypogonadism
:silhouette: gynecomastia, decreasing size of testes
:warning: comorb: T2DM, ESLD, HIV
:check: adult onset, decreased vigor and libido, infertility; PMH of steroids and sustained release opiods
Cushing's
:silhouette: proximal muscle weakness, extremity wasting, peritoneal fat and facial fat, purpilish striae, supraclavicular fat pads, skin thinning
:check: excess sweating, exposure to excess glucocorticoid (exo); rapid weight gain
hypothyroidism
:check: progressive weight gain, cold intolerance, fatigue, dry skin, constipation, myalgia, Hx of thyroidectomy, neck irradiation,, Li or I based drugs
:silhouette: goitre, brachycardia, HTN
Flatus (air)
Bacterial Metabolism
(From carb malabsorption)
:check: gas, abdo pain, flatulence, bowel movements, diarrhoea, weight loss, lactose intolerance, celiac disease; HX of surgery or pancreatic insufficiency
Aerophagia
:check: belching, bloating, abdo pain, abdo distention, gulping food, chewing gum, smoking, anxiety, repetitive belching
:silhouette: percussion can differentiate fluid or solid. If mass or fluid, dull.