![]() Liver profile: hepatitis, cholecystitis, post hepatic biliary tract obstructionĬoagulation profile: status of coagulopathy, bleeding disorders, trauma WBC count: infection/inflammation, though of limited value Signs of dehydration, abdominal tenderness, distension, rebound tenderness, marked rigidity, decreased bowel sound Pseudomembranous colitis, toxic megacolon, perforation UPT, CBC, vaginal swab test for gonorrhoea/chlamydiaĬervical motion/uterine/adnexal tenderness, rebound tendernessĮlderly population, RF: antibiotics (fluoroquinolones, penicillin, clindamycin)Ĭrampy abdominal pain, watery diarrhoea, fever Lower abdominal pain, fever, nausea, vomiting, vaginal discharge Tachycardia, hypotension, peritoneal signs, adnexal mass and tenderness, cervical motion tenderness, blood in vaginal vaultĪge: 15–49 years RF: multiple partners, previous PID Sudden, severe pain, spotting, amenorrhoeaįAST, transvaginal and transabdominal ultrasonography Tachycardia, hypotension, palpable abdominal mass, unequal femoral pulsesįemale of childbearing age, RF: IUCD, previous ectopic, PID Severe sudden onset abdominal pain radiating to back, syncope, GI bleeding, shock Severe colicky flank pain radiating to groin, nausea, vomiting, haematuria, tossing up in bedĪge >50 years, M>F, RF: hypertension, atherosclerotic disease, DM, smoking family history RLQ tenderness, guarding, rebound tenderness, psoas sign, obturator sign Perforation, peritonitis, septicaemia, abscess Periumbilical pain migrates to RLQ, nausea, vomiting, fever Perforation, fistula, obstruction, haemorrhageĪbdominal tenderness, guarding, signs of peritonitis Left lower quadrant pain, fever, change in bowel habits ![]() Mean age: 60 years, M=F, sigmoid colon – most common site Tachycardia, tachypnoea, hypotension, silent abdomen initially, signs of peritonitis Signs of shock, generalized abdominal tenderness, rigidity, signs of peritonitisĮlderly population, M>F, RF: atherosclerosis, arrhythmia, CHF, recent MI, valvular diseasesĭiffuse abdominal pain out of proportion, vomiting, diarrhoeaĬBC, S. ![]() Severe abdominal pain, lies still in bed, abdominal distension, vomiting, fever Tachycardia, diffuse tenderness, tympanic note, hyperactive bowel sound, PR examination – emptyĮlderly age, RF: peptic ulcer, intestinal ulcers, carcinoma Local complications: acute local fluid collection, pseudocyst, necrosis, abscessĪny age, RF: h/o previous abdominal surgeryĬrampy abdominal pain, nausea, vomiting, constipation, abdominal distension Helical CT with contrast, ultrasonography for biliary tract pathology Severe epigastric pain following meal, radiating to back, nausea, vomiting, fever, tachycardia, tachypnoea, hypotension, hyperthermia, epigastric tenderness, guarding, Cullen’s sign, Grey Turner’s signĬBC, S. Jaundice, RUQ tenderness, rebound tenderness, Murphy’s signĪge: 45–60 years, varies with aetiology M>F, aetiology: gallstones, alcohol Ultrasonography – most sensitive, CT scan in extrahepatic biliary obstruction, hepatobiliary scintigraphy Severe epigastric pain 2–5 h after meals or at night, nausea, vomiting, early satietyĪge: 40–60 years, F>M, RF: childbearing age, obese, alcohol, OC pillsĮpigastric/RUQ pain, radiating to right shoulder/subscapular, postprandial pain, nausea, fever Gastro-oesophageal reflux disease, perforationĮpigastric tenderness, no rebound tendernessĪge >50 years, M>F, RF: H. Bedside ultrasound facilitates visualisation of increased abdominal aortic diameter and determines further surgical/medical management.Įpigastric burning pain, associated with food, increases on supine position Elderly patients with history of recent abdominal/flank/low back pain, known hypertension, pulsatile abdominal mass and feeble/absent distal pulses are suggestive of abdominal aortic aneurysm/dissection. Ībdominal aorta, liver and spleen sizes can be evaluated by palpation. Typical rebound tenderness is no longer considered an important examination tool due to painful procedure. Due to lax abdominal wall musculature, guarding and rigidity may be absent in the elderly. Guarding could be voluntary or involuntary. Patients with peritoneal irritation show tenderness, guarding/rigidity and pain with coughing. pain of renal calculus extends from lumbar region to the iliac fossa and groin. However, one can have diffuse abdominal pain spreading to more than one quadrant, i.e. Localisation of tenderness guides physician to generate differential diagnosis pertaining to that area. Abdomen is divided into right upper, right lower, left upper and left lower quadrants. Palpation: Focus on locating the site of tenderness, signs of peritonism and palpation of masses.
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