医
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Retroperitoneal hemorrhage is complication of severe abdominal trauma; often masked by other injuries; mortality up to 42%.
消化内科Retroperitoneal infection/abscess is rare; E. coli/S. aureus/Proteus/Aerobacter/Streptococcus; occasionally anaerobic/TB/Brucella/Actinomyces/Entamoeba. Hard to diagnose.
消化内科Intestinal angina (chronic mesenteric ischemia) is postprandial epigastric/mid abdominal pain from relative intestinal ischemia; middle-aged/elderly males; atherosclerosis. 15-30 min postprandial; 1-3h duration; related to meal size.
消化内科Abdominal muscle absence syndrome (Orbinsky syndrome) is abdominal wall hypoplasia with associated extremity/urinary/GI/cardiac anomalies. Thin parchment-like wall; viscera visible; cannot sit up without arm support; respiratory infection; incomplete form
消化内科Shunt hyperbilirubinemia (Israel syndrome) is excess bilirubin from marrow RBC precursors/ferroheme/tetrapyrrole precursors. Age 10-20; jaundice/splenomegaly; spherocytosis/increased fragility/reticulocytosis/indirect hyperbilirubinemia; normal LFT.
消化内科Functional dyspepsia (FD) is gastroduodenal functional disorder without organic disease; most common functional GI disease.
消化内科Hiccup is involuntary diaphragmatic/intercostal contraction with sudden glottic closure; >24h = intractable. Healthy transient hiccups from diet/rapid eating/cold drinks/alcohol/CO2/cold/smoking. Pathologic: esophageal/mediastinal/CNS disease.
消化内科Pediatric abdominal pain is common; intra/extra-abdominal; organic/functional; medical/surgical.
消化内科Shwachman-Diamond syndrome (1964) is congenital pancreatic insufficiency with bone marrow hypoplasia; infants 2-10 months; familial; autosomal recessive.
消化内科Carcinoid (argentaffinoma) arises from Kulchitsky cells in intestinal mucosa glands; low-grade malignant; local invasion, rare metastasis. Most common in appendix/small intestine/rectum/stomach/duodenum.
消化内科Bile reflux gastritis (alkaline reflux gastritis) is upper abdominal pain/bilious vomiting/distension/weight loss after gastrectomy/gastrojejunostomy; ~5% incidence; Billroth II 2-3x Billroth I.
消化内科Biliary cirrhosis is from biliary tract disease; primary (intrahepatic cholestasis, PBC) vs secondary (extrahepatic obstruction). 90% women; age 40-60; M:F=1:8. Early: fatigue/pruritus; ALP/GGT elevated. Late: liver failure/variceal bleed/encephalopathy/a
消化内科Cronkhite-Canada syndrome (1955) is middle-aged/elderly; multiple GI polyps (juvenile hamartomatous/inflammatory); ectodermal abnormalities; intermittent diarrhea/abdominal pain/limb paresthesia. Age 30-86; M:F=1.5:1.
消化内科Colorectal polyp is any luminal protrusion; neoplastic (adenoma, precancerous) vs non-neoplastic (hamartomatous/juvenile/hyperplastic/inflammatory/lymphoid). Age-related incidence.
消化内科Protein-losing gastroenteropathy is plasma protein (especially albumin) loss through GI mucosa; systemic edema/hypoproteinemia.
消化内科Fifth day syndrome (post-appendectomy) is abdominal pain/high fever on day 4-5 (rare day 8) after uncomplicated pediatric appendectomy, progressing to diffuse peritonitis. Unknown; immune deficiency.
消化内科Cholestatic jaundice is elevated bile acids and conjugated bilirubin; from hepatocellular excretion dysfunction or intra/extrahepatic obstruction.
消化内科Bouveret syndrome is gallstone ileus; recurrent biliary inflammation adheres to duodenum/hepatic flexure/stomach; stone erodes through fistula obstructing small bowel. 1-3% mechanical small bowel obstruction.
消化内科Biliary hypotonia syndrome (Chiray syndrome) is delayed gallbladder emptying from low biliary tone; dyspepsia/fat intolerance/RUQ pain. Also gallbladder atony syndrome.
消化内科Biliary tract dyskinesia syndrome (sphincter of Oddi dysfunction, SOD) includes papillitis/papillary stenosis/postcholecystectomy syndrome. Postcholecystectomy biliary pain is focus. ERCP manometry is gold standard.
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