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__NOTOC__
'''For patient information click [[Abdominal distension (patient information)|here]]'''
{{Infobox_Disease |
{{Infobox_Disease |
  | Name          = {{PAGENAME}}
  | Name          = {{PAGENAME}}
  | Image          = Bowel obstruction.jpg
  | Image          = Bowel obstruction.jpg
| Caption        =
| DiseasesDB    = 30819
| ICD10          = {{ICD10|R|14||r|10}}, {{ICD10|R|19|0|r|10}}
| ICD9          = {{ICD9|787.3}}, {{ICD9|789.3}}
| ICDO          =
| OMIM          =
| MedlinePlus    =
| eMedicineSubj  =
| eMedicineTopic =
| MeshID        =
}}
}}
{{Search infobox}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}; {{MUT}}
==Overview==
* '''Abdominal distension''' must be evaluated carefully and systematically. The first concern is to rule out a serious diagnosis such as [[abdominal aneurysm]].
* Importance of evaluation:
:* To rule out serious diagnoses
:* To evaluate mundane diagnoses
:*:* [[Overeating]]
:*:* [[Swallowing air]]
* Attention to history and physical examination is important to formulate plan of diagnosis
==Causes in Alphabetical Order==
'''Abdominal distension''' (or "distended abdomen") can be a sign of many other conditions, including:In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
* [[Abdominal abscess]]
* [[Abdominal aneurysm]]
* [[Abdominal trauma]] with intra-abdominal [[bleeding]]
* [[Acanthocytosis]]
* [[Acute appendicitis]]
* [[Air swallowing]] (nervous habit)
* [[Ascites]]
*:* [[Congestive Heart Failure]]
:* [[Hypoalbuminemia]] (e.g. [[malnutrition]], [[liver failure]])
:* [[Metastatic cancer]] (e.g., colon, ovarian)
:* [[Nephrotic syndrome]]
:* [[Portal hypertension]] (e.g. [[cirrhosis]])
* [[Biliary Atresia]]
* [[Blind loop syndrome]]
* [[Chylous ascites]]
* [[Cirrhosis]]
* [[Colonic pseudo-obstruction]] ([[Ogilvie's Syndrome]])
* [[Colonic volvulus]]
* [[Congenital hepatic porphyria]]
* [[Congenital megacolon]]
* Congenital short bowel
* [[Congenital tuberculosis]]
* [[Constipation]]
* [[Diverticulitis]]
* End stage [[liver failure]]
* Functional gas/[[constipation]]
* Gas/bloat syndrome
* [[Granulosa cell tumor]] of the [[ovary]]
* [[Heart failure]]
* [[Helminthiasis]]
* Hepatorenal [[tyrosinemia]]
* [[Hirschsprung disease]]
* [[Hypothyroidism]]
* Idiopathic sclerosing mesenteritis
* [[Ileus]]
* [[Infectious diarrhea]]
* [[Irritable bowel syndrome]]
* Jirásek-Zuelzer-Wilson syndrome
* [[Lactose intolerance]]
* [[Large bowel obstruction]]
* [[Leukemia]]
* [[Lymphoma]]
* [[Meconium]] plug syndrome
* [[Metastatic cancer]] (e.g., colon, ovarian)
* [[Necrotizing enterocolitis]]
* Neonatal [[sepsis]]
* [[Nephrotic syndrome]]
* [[Obesity]]
* [[Ovarian hyperstimulation syndrome]] [[OHSS]]
* [[Ovarian cancer]]
* [[Ovarian cyst]]
* [[Overeating]]
* [[Pancreatitis]] and complications (pseudocyst)
* [[Paralytic ileus]]
* Peritoneal bleeding
* [[Peritonitis]]
* [[Polycystic Liver Disease]]
* [[Pregnancy]]
* [[Premenstrual syndrome]]
* Sclerosing mesenteritis
* [[Small bowel obstruction]]
* Smith's disease
* [[Spontaneous bacterial peritonitis]] (SBP)
* Stalker-Chitayat syndrome
* [[Toxic megacolon]]
* [[Trauma]]
* [[Umbilical hernia]] or [[ventral hernia]]
* Urethral obstruction sequence
* Urorectal septum malformation sequence
* Valvular dysplasia of the child
* [[Variegate porphyria]]
* [[Weight gain]]
* Wolman syndrome
Other:


Pseudomyxoma peritonei
{{Abdominal distension}}


Clostridium Difficile
{{CMG}}; {{AE}} {{CZ}}; {{MUT}}
Ascites
Hookworm
Drowning
Pelvic Masses
Ileus
Pseudocyesis
Pulmonary hypertension
Volvulus


Eosinophilic gastroenteritis
{{SK}} Distended abdomen; abdominal swelling; swelling in the abdomen; swollen belly
Ulcerative colitis
Strongyloidiasis
Toxic megacolon
Soiling
Bloating
Necrotizing enterocolitis
Intestinal pseudoobstruction
Cardiac tamponade
Enteritis
Jugular venous pressure
Ischemic colitis
SSRI discontinuation syndrome


Bowel obstruction
== [[Abdominal distension overview|Overview]] ==
Autonomic dysreflexia
Islet cell transplantation


Infectious hematopoietic necrosis virus
== [[Abdominal distension pathophysiology|Pathophysiology]] ==
Cordyceps
Ovarian hyperstimulation syndrome
Necrotising enterocolitis
Distension


===Causes of Abdominal Distension by Organ System===
== [[Abdominal distension causes|Causes]] ==
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |
[[Abdominal aneurysm]],
[[Congestive Heart Failure]],
[[Heart failure]],


|-
== [[Abdominal distension differential diagnosis|Differentiating Abdominal Distension from other Diseases]] ==
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Congenital'''
|bgcolor="Beige"|
[[Congenital hepatic porphyria]],
[[Congenital megacolon]],
Congenital short bowel,
[[Congenital tuberculosis]],
[[Hirschsprung's disease]],
Jirásek-Zuelzer-Wilson syndrome,
[[Meconium]] plug syndrome,


|-
== [[Abdominal distension epidemiology and demographics|Epidemiology and Demographics]] ==
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|
[[Ovarian hyperstimulation syndrome]] [[OHSS]],


|-
== [[Abdominal distension risk factors|Risk Factors]] ==
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|
[[Hypothyroidism]],


|-
== [[Abdominal distension natural history, complications and prognosis|Natural History, Complications and Prognosis ]] ==
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|
[[Abdominal abscess]],
[[Acute appendicitis]],
[[Ascites]],
[[Biliary Atresia]],
[[Cirrhosis]],
[[Colonic volvulus]],
[[Constipation]],
[[Diverticulitis]],
Idiopathic sclerosing mesenteritis,
[[Ileus]],
[[Large bowel obstruction]],
[[Necrotizing enterocolitis]],
[[Pancreatitis]] and complications (pseudocyst),
Peritoneal bleeding,
[[Peritonitis]],
 
 
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"|
[[Polycystic Liver Disease]],
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|
[[Acanthocytosis]],
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"|
[[Blind loop syndrome]],
[[Colonic pseudo-obstruction]] ([[Ogilvie's Syndrome]]),
 
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|
[[Helminthiasis]],
[[Toxic megacolon]],
 
 
 
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|
[[Acute intermittent porphyria]],
Hepatorenal tyrosinemia]],
[[Lactose intolerance]],
[[Overeating]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"|
[[Ovarian cancer]],
[[Pregnancy]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"|
[[Granulosa cell tumor]] of the [[ovary]],
[[Leukemia]],
[[Lymphoma]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"|
[[Nephrotic syndrome]],
 
 
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|
[[Abdominal trauma]] with intra-abdominal [[bleeding]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"|
Air swallowing (nervous habit),
Functional gas/constipation,
Gas/bloat syndrome,
[[Obesity]],
[[Umbilical hernia]] or [[ventral hernia]],
 
|-
|}
 
==Diagnosis==
 
=== History ===
* [[Diarrhea]]
* [[Weight gain]]
* Duration
* Flatus
* [[Reflux]]
* Last bowel movement
* Last [[menstrual period]]
* Sexual history
* Presence of [[fever]]
* Constitutional symptoms
 
=== Physical Examination ===
* In women, pelvic exam
* Fluid wave
* Signs:
*:* [[Cirrhosis]]
*:* [[Portal hypertension]]
==== Abdomen ====
* Abdominal exam
*:* Masses
*:* Palpitation for hernias
* Abdominal tenderness
=== Laboratory Findings ===
* [[Complete blood count]] ([[CBC]])
* [[Stool culture]]s
* [[Pregnancy test]]
* [[Erythrocyte sedimentation rate]] ([[ESR]])
* Liver workup ([[liver function test]]s, [[biopsy]], [[hepatitis]] panel)
 
=== MRI and CT ===
* Pelvic and abdominal [[CT scan]]s could reveal:
*:* [[Cirrhosis]]
*:* Ovarian masses
*:* [[Pseudocyst]]s
*:* [[Aneurysm]]s
 
=== Echocardiography or Ultrasound ===  
* Pelvic and abdominal ultrasound may reveal:
*:* Ovarian mass
*:* [[Pregnancy]]
*:* [[Ascites]]
*:* [[Liver disease]]
 
=== Other Imaging Findings ===
* KUB x-rays ([[kidney]], [[ureter]], [[bladder]])
*:* Could reveal [[paralytic ileus]], [[constipation]], [[air swallowing]], [[bowel obstruction]]
 
=== Other Diagnostic Studies ===
* [[Biopsy]] for masses/tumors
* [[Endoscopy]] (lower gastrointestinal) may be performed to rule out any organic pathology before [[irritable bowel syndrome]] can be diagnosed.
* [[Paracentesis]] may provide symptomatic relief and is diagnostic for [[spontaneous bacterial peritonitis]] (SBP) and malignant [[ascites]].


== Diagnosis ==


[[Abdominal distension history and symptoms|History and Symptoms]] | [[Abdominal distension physical examination|Physical Examination]] | [[Abdominal distension laboratory findings|Laboratory Findings]] | [[Abdominal distension x ray|X Ray]] | [[Abdominal distension CT|CT]] | [[Abdominal distension MRI|MRI]] | [[Abdominal distension ultrasound|Ultrasound]] | [[Abdominal distension other imaging findings|Other Imaging Findings]] | [[Abdominal distension other diagnostic studies|Other Diagnostic Studies]]


== Treatment ==
== Treatment ==
* For [[malabsorption]], reduce milk intake and change diet
* For [[bowel obstruction]], [[pancreatitis]] (for example), [[nasogastric tube]] decompression and bowel rest (when indicated)
* For swallowing air, awareness is key:
*:* Sip hot beverages
*:* Avoid carbonated beverages
*:* Chew gum/suck on candies
*:* Eat slowly
*:* Drink through a straw
* Treatment of underlying [[liver disease]]s (management of complications)
* Increase dietary fiber, reduce stress, and [[antispasmodic]]s for [[irritable bowel syndrome]]
=== Acute Pharmacotherapies ===
* For [[constipation]], [[laxative]]s
* For [[spontaneous bacterial peritonitis]] (SBP), [[antibiotic]]s
== Surgery and Device Based Therapy ==
* Referral for [[hernia]]s (if and when appropriate)
==References==
{{reflist|2}}


==See also==
[[Abdominal distension medical therapy|Medical Therapy]] | [[Abdominal distension surgery|Surgery]] | [[Abdominal distension primary prevention|Primary Prevention]] | [[Abdominal distension cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Abdominal distension future or investigational therapies|Future or Investigational Therapies]]
* [[Gastric distension]]
* [[Bloating]]


{{WikiDoc Help Menu}}
== Case Studies ==
{{WikiDoc Sources}}
[[Abdominal distension case study one|Case #1]]
{{WH}}
{{WS}}


[[Category:Digestive disease symptoms]]
[[Category:Digestive disease symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Symptoms]]
[[Category:Physical examination]]
[[Category:Physical examination]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]

Latest revision as of 20:06, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; M.Umer Tariq [3]

Synonyms and keywords: Distended abdomen; abdominal swelling; swelling in the abdomen; swollen belly

Overview

Pathophysiology

Causes

Differentiating Abdominal Distension from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

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Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1 Template:WH Template:WS