|
|
| Line 8: |
Line 8: |
| ==Differentiating Toxic Megacolon from other Diseases== | | ==Differentiating Toxic Megacolon from other Diseases== |
| *Toxic megacolon must be differentiated from other diseases that cause [[abdominal pain]], [[fever]],[[diarrhea]] such as [[acute appendicitis]], [[acute diverticulitis]], [[inflammatory bowel disease]], [[whipple's disease]], [[tropical sprue]], [[infective colitis]], [[viral hepatitis]] ([[hepatitis A]] and [[hepatitis E]]), [[liver abscess]], [[spontaneous bacterial peritonitis]], [[mesenteric ischemia]], and [[Acute (medicine)|acute]] [[ischemic colitis]]. | | *Toxic megacolon must be differentiated from other diseases that cause [[abdominal pain]], [[fever]],[[diarrhea]] such as [[acute appendicitis]], [[acute diverticulitis]], [[inflammatory bowel disease]], [[whipple's disease]], [[tropical sprue]], [[infective colitis]], [[viral hepatitis]] ([[hepatitis A]] and [[hepatitis E]]), [[liver abscess]], [[spontaneous bacterial peritonitis]], [[mesenteric ischemia]], and [[Acute (medicine)|acute]] [[ischemic colitis]]. |
|
| |
| ===Preferred Table===
| |
| <span style="font-size:85%">'''Abbreviations:'''
| |
| '''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''IV'''= Intravenous, '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CXR'''= Chest X ray, '''IgA'''= [[Immunoglobulin A]], '''IgG'''= [[Immunoglobulin G]], '''IgM'''= [[Immunoglobulin M]], '''CT'''= [[Computed tomography]], '''[[PMN]]'''= Polymorphonuclear cells, '''[[ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[CRP]]'''= [[C-reactive protein]], TS= [[Transferrin saturation]], SF= Serum [[Ferritin]], SMA= [[Superior mesenteric artery]], SMV= [[Superior mesenteric vein]], ECG= [[Electrocardiogram]]</span>
| |
|
| |
| {| align="center"
| |
| |-
| |
| |
| |
| {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| | colspan="13" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations'''
| |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis
| |
| ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms'''
| |
| ! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic megacolon|'''Toxic megacolon''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Anemia]]
| |
| *[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]]
| |
| *[[Hypoalbuminemia]]
| |
| *[[Metabolic alkalosis]] associated with a poor [[prognosis]]
| |
| *[[Metabolic acidosis]] secondary to [[ischemic colitis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT and [[Ultrasound]] shows:
| |
| *Loss of colonic haustration
| |
| *Hypoechoic and thickened bowel walls with irregular internal margins in the [[sigmoid]] and descending colon
| |
| *Prominent dilation of the transverse colon (>6 cm)
| |
| * Insignificant dilation of ileal bowel loops (diameter >18 mm) with increased intraluminal gas and fluid
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute appendicitis|'''Acute appendicitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Starts in [[epigastrium]], migrates to RLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in pyogenic appendicitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in perforated appendicitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ct scan
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Positive Rovsing sign
| |
| * Positive Obturator sign
| |
| * Positive Iliopsoas sign
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diverticulitis|'''Acute diverticulitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |LLQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |−
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in perforated diverticulitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CT scan
| |
| * Ultrasound
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * History of [[constipation]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Inflammatory bowel disease|'''Inflammatory bowel disease''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Anti-neutrophil cytoplasmic antibody]] ([[P-ANCA]]) in [[Ulcerative colitis]]
| |
| * [[Anti saccharomyces cerevisiae antibodies]] (ASCA) in [[Crohn's disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[String sign]] on [[abdominal x-ray]] in [[Crohn's disease]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| Extra intestinal findings:
| |
| * [[Uveitis]]
| |
| * [[Arthritis]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Whipple's disease|'''Whipple's disease''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Thrombocytopenia]]
| |
| * [[Hypoalbuminemia]]
| |
| * [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis.
| |
| Images used to find complications
| |
| *[[Whipple's disease x ray|Chest and joint x-ray]]
| |
| *[[Whipple's disease CT|CT]]
| |
| *[[Whipple's disease MRI|MRI]]
| |
| *[[Whipple's disease ultrasound|Echocardiography]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings:
| |
| * [[Uveitis]]
| |
| * [[Endocarditis]]
| |
| * [[Encephalitis]]
| |
| * [[Dementia]]
| |
| * [[Hepatosplenomegaly]]
| |
| * [[Arthritis]]
| |
| * [[Ascites]]
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |'''Disease'''
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tropical sprue|'''Tropical sprue''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Fat soluble vitamin deficiency
| |
| * [[Hypoalbuminemia]]
| |
| * Fecal stool test
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Barium studies:
| |
| * Dilation and edema of mucosal folds
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Steatorrhea]]- 10-40 g/day (Normal=5 g/day)
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infective colitis|'''Infective colitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in fulminant colitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Stool culture]] and studies
| |
| * Shiga toxin in bloody diarrhea
| |
| * [[PCR]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan
| |
| * Bowel wall thickening
| |
| * Edema
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |'''Disease'''
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo-
| |
| tension
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis|'''Viral hepatitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in Hep A and E
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in fulminant hepatitis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in acute
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Abnormal LFTs
| |
| * Viral serology
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Hep A and E have fecal-oral route of transmission
| |
| * Hep B and C transmits via blood transfusion and sexual contact.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess|'''Liver abscess''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * CBC
| |
| * Blood cultures
| |
| * Abnormal [[Liver function test|liver function tests]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * US
| |
| * CT
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Spontaneous bacterial peritonitis|'''Spontaneous bacterial peritonitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in cirrhotic patients
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hypoactive
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ascitic fluid [[PMN]]>250 cells/mm<small>³</small>
| |
| * Culture: Positive for single organism
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Ultrasound for evaluation of liver cirrhosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mesenteric ischemia|'''Mesenteric ischemia''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Periumbilical
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive if bowel becomes gangrenous
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive to absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]] and [[lactic acidosis]]
| |
| * [[Amylase]] levels
| |
| * [[D-dimer]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT angiography
| |
| * SMA or SMV thrombosis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * Also known as abdominal angina that worsens with eating
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ischemic colitis|'''Acute ischemic colitis''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Diffuse
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | −
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Hyperactive then absent
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * [[Leukocytosis]]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Abdominal x-ray]]
| |
| * Distension and pneumatosis
| |
| CT scan
| |
| * Double halo appearance, thumbprinting
| |
| * Thickening of bowel
| |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| |
| * May lead to shock
| |
| |-
| |
| |}
| |
| |}
| |
|
| |
|
| ==References== | | ==References== |
