7/23/2019 Abdominal Managemant

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Summary on some of the gastrointestinal (GI) cases

Inammatory Bowel Disease (IBD)

• Bloody diarrhea

•

Family history of inammatory bowel disease• Weight loss and low-grade fever

• Arthritis and erythema nodosum

• Flexible sigmoidoscopy is diagnostic

Irritable bowel syndrome (IBS)

• Alternating constipation and diarrhea

• Normal laboratory tests

• Normal exible sigmoidoscopy

Diverticulitis

• Left lower uadrant abdominal pain! fever! leu"ocytosis! and possibly

diarrhea and#or constipation

• $iagnosis established with %& scan

• Admit to hospital for '( antibiotics! hydration! and nothing by mouth for sever

disease

• )utpatient treatment with oral antibiotics for milder disease

• No colonoscopy or barium enema during acute episode

• *urgery may be necessary if there is no improvement or if complications such

as peritonitis develop

• +ecommend high-,ber diet after episode

Appendicitis

• 'nitially! periumbilical pain that typically localies in the right lower uadrant!

fever! anorexia! nausea! and vomiting

• Leu"ocytosis is common. pyuria and microscopic hematuria maybe present

• /ain on passive exion and internal rotation of right hip 0)bturator sign1

• /ain on passive extension of right hip 0/soas *ign1

•  &enderness on rectal examination

• 'maging studies typically not necessary. ultrasound and %& scan maybe

helpful

• *urgical treatment is necessary

alabsorption

• (oluminous foul-smelling stool

• /ossible history of chronic pancreatitis or cystic ,brosis

• Weight loss and malnutrition

• Laboratory evidence of vitamin de,ciencies and anemia