医
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Psychogenic vomiting is recurrent vomiting without organic cause, associated with psychological stress/emotional conflict; treat by psychotherapy, CBT, family therapy.
消化内科Alpha-1 antitrypsin deficiency causes early panacinar emphysema (lower-lobe) and liver cirrhosis in adults; inherited SERPINA1; treat by smoking cessation, augmentation therapy, transplant.
消化内科Hyponatremia is serum sodium <135 mmol/L: headache, nausea, seizures, cerebral edema; causes SIADH/hypovolemic/hypervolemic; correct cautiously, avoid central pontine myelinolysis.
消化内科Cystic fibrosis is autosomal-recessive CFTR defect affecting exocrine glands: recurrent lung infection/bronchiectasis, pancreatic insufficiency, steatorrhea, meconium ileus; treat by airway clearance/enzymes/CFTR modulators.
消化内科Gilbert syndrome is benign unconjugated hyperbilirubinemia (UGT1A1 polymorphism): mild fluctuating jaundice on fasting/stress; no treatment needed.
消化内科Galactosemia is GALT deficiency causing galactose accumulation: jaundice, vomiting, cataracts, liver failure, intellectual disability; newborn screening; galactose-free diet.
消化内科Diabetic gastroparesis is delayed gastric emptying from autonomic neuropathy in long-standing diabetes, causing postprandial bloating, nausea, vomiting, erratic glycemic control.
消化内科Hypersplenism is a syndrome of splenomegaly with one/multiple cytopenias, marrow hyperplasia, relieved by splenectomy. Secondary to portal hypertension, hematologic disease, infection, storage disease.
消化内科Iron-deficiency dysphagia = a thin membrane within the esophageal lumen; classified by level as upper/middle/lower esophageal web, upper most common. Most patients asymptomatic (found on health check/barium study); a few have dysphagia; rare in China.
消化内科Rare symptoms; late presentation (complications/malignant change). Pyloric benign tumors: obstruction/pedunculated adenoma prolapse; self-resolving; rare congestion/edema/intussusception/necrosis/perforation/peritonitis. Ulcer = discomfort/pain/bleeding;
消化内科Primary retroperitoneal lipoma; excludes renal/adrenal/pancreatic parenchymal lipomas.
消化内科Parasitic diseases: parasites invading humans; lesions/clinical vary by species/site. Worldwide, tropics/subtropics, poor sanitation. Drug treatment = most effective anthelmintic per species.
消化内科Intestinal parasitosis: parasites in GI tract (protozoa/helminths: Ascaris/hookworm/pinworm/tapeworm/whipworm/amoeba/Giardia/Trichomonas). Lesions not limited to gut. Treat with species-specific anthelmintics; supportive care; surgical complications.
消化内科Anisakiasis: Anisakis L3 larvae in GI tract; raw marine fish. Japan/West; acute: nausea/vomiting/severe abdominal pain/eosinophilia; chronic: eosinophilic gastric/intestinal granuloma; obstruction/perforation/peritonitis.
消化内科Enterobiasis (pinworm): perianal/pruritus vulvae; worldwide; 300-500 million infected; children higher (40-70%); institutional outbreaks.
消化内科Ascariasis: Ascaris lumbricoides in small intestine/other organs; common in China, children. Intestinal: asymptomatic or GI symptoms. Ectopic: bile duct/pancreas/appendix/liver/lung/eye/brain/thyroid/spinal cord; cholangitis/pancreatitis/appendicitis/obst
消化内科Biliary ascariasis: Ascaris migrates retrograde from small intestine into biliary tree → Oddi sphincter spasm; sudden upper abdominal pain. Mostly common bile duct; can enter intrahepatic ducts. Children/young adults, rural. Complications: cholangitis/liv
消化内科Mansonelliasis perstans: Mansonella perstans in body cavities (pleural/pericardial/peritoneal), mesentery, perirenal, retroperitoneal tissues.
消化内科Dracunculiasis (Guinea worm infection): adult Dracunculus medinensis in deep connective/subcutaneous tissue, protruding externally. Main lesion: chronic skin ulcer.
消化内科Sparganosis = Spirometra mansoni plerocercoid in subcutaneous tissues; ingestion of undercooked frog/snake, drinking infected water with copepods, or applying raw frog flesh to wounds/eyes. Temporary paratenic host.
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