Abdominal distension

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Abdominal distension
ICD-10 R14, R19.0
ICD-9 787.3, 789.3
DiseasesDB 30819

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; M.Umer Tariq [3]

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:
  • Attention to history and physical examination is important to formulate plan of diagnosis

Complete Differential Diagnosis of Causes of Abdominal Distension

Abdominal distension (or "distended abdomen") can be a sign of many other conditions, including:In alphabetical order. [1] [2]

Other:

Pseudomyxoma peritonei

Clostridium Difficile Ascites Hookworm Drowning Pelvic Masses Ileus Pseudocyesis Pulmonary hypertension Volvulus

Eosinophilic gastroenteritis Ulcerative colitis Strongyloidiasis Toxic megacolon Soiling Bloating Necrotizing enterocolitis Intestinal pseudoobstruction Cardiac tamponade Enteritis Jugular venous pressure Ischemic colitis SSRI discontinuation syndrome

Bowel obstruction Autonomic dysreflexia Islet cell transplantation

Infectious hematopoietic necrosis virus Cordyceps Ovarian hyperstimulation syndrome Necrotising enterocolitis Distension

Complete Differential Diagnosis of the Causes of Abdominal distension

(By organ system)

Cardiovascular

Abdominal aneurysm, Congestive Heart Failure, Heart failure,

Chemical / poisoning No underlying causes
Congenital

Congenital hepatic porphyria, Congenital megacolon, Congenital short bowel, Congenital tuberculosis, Hirschsprung's disease, Jirásek-Zuelzer-Wilson syndrome, Meconium plug syndrome,

Dermatologic No underlying causes
Drug Side Effect

Ovarian hyperstimulation syndrome OHSS,

Ear Nose Throat No underlying causes
Endocrine

Hypothyroidism,

Environmental No underlying causes
Gastroenterologic

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,


Genetic

Polycystic Liver Disease,

Hematologic

Acanthocytosis,

Iatrogenic

Blind loop syndrome, Colonic pseudo-obstruction (Ogilvie's Syndrome),

Infectious Disease

Helminthiasis, Toxic megacolon,


Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic

Acute intermittent porphyria, Hepatorenal tyrosinemia]], Lactose intolerance, Overeating,

Obstetric/Gynecologic

Ovarian cancer, Pregnancy,

Oncologic

Granulosa cell tumor of the ovary, Leukemia, Lymphoma,

Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte

Nephrotic syndrome,


Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma

Abdominal trauma with intra-abdominal bleeding,

Urologic No underlying causes
Miscellaneous

Air swallowing (nervous habit), Functional gas/constipation, Gas/bloat syndrome, Obesity, Umbilical hernia or ventral hernia,

Diagnosis

History

Physical Examination

Abdomen

  • Abdominal exam
    • Masses
    • Palpitation for hernias
  • Abdominal tenderness

Laboratory Findings

MRI and CT

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies


Treatment

Acute Pharmacotherapies

Surgery and Device Based Therapy

  • Referral for hernias (if and when appropriate)

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

See also


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