01 - Signs and Symptoms of Git Disorders

7/25/2019 01 - Signs and Symptoms of Git Disorders

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SIGNS AND SYMPTOMS OF

GIT DISORDERS

M. JUFRI MAKMUR



DEFINITION

• Symptom : Subjective data o patie!t"#comp$ai!t#

• Symptom i# t%e mo#t impo&ta!t t%i!' i!di&ecti!' o& 'uidi!' a dia'!o#tic ()*+,

• Si'! : Objective data o p%y#ica$-!di!'#

• Ree&e!ce#: Adam"# /%y#ica$ D0 1a&i##o! Si'!# 2 Symptom#

3a&ba&a 3ate# A 4uide to /%y#ica$E0ami!atio! a!d 1i#to&y Ta5i!'



Dia'!o#tic /&ocedu&e

• SOA/

S Subjective (ide!tity6 #ymptom#6c$i!ica$ %i#to&y6 'e!etic#,

O Objective (#i'!#6 $abo&ato&y6&adio$o'ic6 etc,

A A##e#me!t (dia'!o#tic 2 DD,

/ /$a!!i!' (t&eatme!t6 #uppo&ti!'e0ami!atio!,



3a#ic o Symptom# a!d Si'!#

• A!atomica$

7 topo'&ap%y

7 va#cu$a&i8atio!• /%y#io$o'ica$

7 o&'a! u!ctio!

7 metabo$i#m





O&'a! Fu!ctio!

• E#op%a'u#7 #a$$oi!'

• 4a#te& 2 Duode!um

7 di'e#tive a!d ab#o&btio!• ;ive&

7 a!abo$i#m a!dcatabo$i#m

7 deto0i-catio!7 e&it&opoe#i#e0t&amedu$$a&7 bi$e #ec&etio!



• /a!c&ea#

7 %o&mo!e #ec&etio!

7 e!8yme #ec&etio!• <o$o!

7 &eab#o&btio!

7 aeca$ o&matio!

• Recta$7 aeca$ &e#e&voa&



S9MTOM/S

• =. Abdomi!a$ pai!• >. Abdomi!a$ di#te!#io!• ?. Dy#p%a'ia• @. Odi!op%a'ia

• . 1iccup o& Si!'u$tu#• ). Bomitu# 2 Re'u&'ita#io!• C. 3$oati!'• . 1emateme#i#

• . Me$e!a• =*. Dia&%ea• ==. <o!#tipatio!• =>. 1ematoc%e8ia





• Type# o abdomi!a$ pai!:

7 epi'a#t&ic pai! 'a#t&oduode!iti#6

pa!c&eatiti#6 I!e&io& M<I6 $et $ive&

abce##6 %epatic di#o&de&#6 $ymp%oma6

a!eu&i#ma ao&ta

7 3i$ia&y co$ic pai! &om t%e &i'%t

%ypoc%o!d&ia$ #p&ead to &i'%t bac5

#%ou$de& 'a$$#to!e 2 <3D #to!e



7 Re!a$ co$ic

pai! &om bac5 <BA#p&ead to

&i'%t i$iac &e'io! ob#t&uctive u&opat%y

7 Ri'%t %ypoc%o!d&ia$ pai! %epaticdi#o&de&#6

'a$$ di#o&de&#6 p$eu&iti#6 TU4 di#o&de&#6

a!d co$o! di#o&de&#



7 ;et %ypoc%o!d&ia$ /ai! 'a#t&iti#6

p#eudocy#t pa!c&ea#6 co$o! di#o&de&#

TU4 di#o&de&#6 p$eu&iti#6 a!d #p$ee!

di#o&de&# 7 Umbi$ica$ pai! 'a#t&iti#6 e!te&iti#6

co$iti#6 a!eu&i#ma ao&ta6 t&ombo#i# ome#e!te&ic

a&te&y 7 Ri'%t 2 ;et ;umba$ pai! co$o! di#o&de&# 6

TU4 di#o&de&#6 p#oa# abce##



7 Ri'%t I$iac pai! appe!diciti#6 co$o!

di#o&de&#6 p#oa# abce##6 /ID6 ova&y cy#t6

i$eiti# te&m.6 TU4 di#.

7 ;et I$iac pai! co$o! di#o&de&#6 p#oa#

abce##6 /ID6 ova&y cy#t6 TU4 di#o&de&#



7 Sup&apubic pai! cy#titi# 2b$adde&

#to!e6 'y!aeco$o'ic di#o&de&#6p&o#tat

di#o&de&#6 co$o7&ecta$ di#o&de&#

7 %o$e abdome! pai!

pe&ito!iti#6mu#c$e pai!6 'a#t&oe!te&iti#6 co$iti#



>. Abdomi!a$ Di#te!tio!

• Due to: 'a#6 Guid6 ma##6 o&'a!ome'a$i

• it% o& it%out pai! H

• Acute6 &ecu&e!t6 o& c%&o!ic H• 3oe$ o& mictu&ia a$te&atio! H

• O&'a! i!vo$ved: 4IT6 TU46 1ea&t



?. Dy#p%a'ia

• Dicu$ty #a$$oi!'

• Due to pai!6 ob#t&uctio!6 ab!. pe&i#ta$#i#6

o& impai&ed &eGe0 (!e&ve,• O&'a! i!vo$ved e#op%a'u# o&

o&op%a&y!0

• Mo#t commo! ca#e: St&ictu&e e#op%a'u#6 ma$i'!a!cy6 4ERD6 mu$tip$e #c$e&o#i#





. 1iccup o& Si!'u$tu#

• I!vo$u!ta&y #pa#modic co!t&actio! ot%e diap%&a'm o$$oed by #udde!c$o#u&e o '$otti#

• Due to i!c&ea#e o i!t&ac&a!ia$p&e##u&e6 abdomi!a$ di#te!tio!6'a#t&ic di$atatio! o& i!Gammatio!6

a!d &e!a$ ai$u&e6 dec&ea#e #e&um$eve$# o ca&bo!dio0ide



). Bomitu# 2 Re'u&'itatio!

• ReGu0 o 'a#t&ic co!te!t#

• T%e die&e!ce it% o& it%outco!t&actio!

• I!vo$ved va'a$ mec%a!i#m

• No! #peci-c a$$ o 4IT di#o&de&#



C. 3$oati!'

• Fu$$ #e!#atio! o #tomac%

• Due to i!Gammatio!6 'a#t&icemptyi!' di#o&de&#6 'a#t&ic ma##6I!c&ea#e o 'a#t&ic p&e##u&e6 i!c&ea#eo 'a# p&oductio!6 u$$ o& pa&tia$ob#t&uctio!



. 1emateme#i#

• 3$eedi!' o uppe& 4IT ($i'. t&eit8,• Due to va&icea$ &uptu&e6 u$ce&6 e&otio!6

ma##

• O&'a! i!vo$ved e#op%a'u#6 #tomac%62 duode!um

• ;ie t%&eate!i!' #ymptom#



. Me$e!a

• 3$ac5 b$oody #too$ &om uppe& 4IT

• 3$ac5 co$o& i# due to o0idatio! o 1b

• <au#ed a!d o&'a! i!vo$ved #imi$a& to%emateme#i#

• ;ie t%&eate!i!' #ymptom



=*. Dia&&%ea

• ate&&y #too$ mo&e t%a! ? 0day

• Acute o& c%&o!ic H ( > ee5# ,

• Due to &eab#o&btio! impai&me!t(o#motic6 to0i!6etc, o& %ype&pe&i#ta$tic(%ype&t%y&oid,

• O&'a! i!vo$ved I!te#ti!a$ a!dco$o&ecta$



==. <o!#tipatio!

• No deecatio! mo&e t%a! ? day#

• Due to ob#t&uctio!6 %ypope&i#ta$tic6

i!Gammatio!6 medicatio!• O&'a! i!vo$ved <o$o&ecta$



=>. 1emato#c%e8ia

• F&e#% &ed b$oody #too$

• Due to $oe& 4IT

• 1aemo&%oid i# t%e mo#t commo!cau#e o %emato#c%e8ia

• Acute6&eccu&e!t6 o& c%&o!ic H

• 3oe$ %abit a$te&atio! H



Si'!#

• F&om p%y#ica$ -!di!'#

• Mo#t commo! i! %epatobi$$ia&ydi#o&de&#

• 4e!e&a$ : vita$ #i'!

• Speci-c : i!#pectio!6 pa$patio!6pe&cu#io!6 a!d au#cu$tatio!

• 4e!t$e

• Ri'%t #ide o patie!t#



=. Me!ta$ <%a!'e

• Mo#t commo! i! e!d #ta'e o ci&&%o#i#o& #eve&e %epatic di#o&de&#

• <a$$ed a# e!cep%a$opat%y %epatic• Due to a$#e !eu&ot&a!#mitte&

(a&omatic ami!o acid#6 ammo!ia,

• Sometime# accompa!ied by Gappi!'t&emo&



>. Icte&ic o& Jau!dice

• A ye$$o di#co$o&atio! o t%e #5i!6mucou# memb&a!e#6 o& #c$e&a o t%eeye#

• Si'!# o e0ce##ive $eve$# o co!ju'atedo& u!co!ju'ated bi$i&ubi! i! t%e b$ood

• Type : /&e%epatic6 1epatic6 a!d

/o#t%epatic• <ommo!$y accompa!ied by p&u&itu#

becau#e bi$e pi'me!t dama'e #e!#o&y

!e&ve (%epatic o& po#t%epatic jau!dice,





• Tea da&5 co$o&ed u&i!e6 c$ay co$o&ed #too$#a$ay# accoppa!y ob#t&uctive o& po#t%epatic jau!dice

• /&e%epatic jau!dice %emo$y#i#

• 1epatic jau!dice %epatic di#o&de&#6co!'e#tive $ive& (%ea&t,6 #y#temic i!Gammatio!(#ep#i#6 $upu#,6 ma$i'!a!cy6 a!d d&u'#

• /o#t%epatic jau!dice <3D #to!e6 ma$i'!a!cyo bi$$ia&y #y#tem6 $ymp%oma



jaundice

i



?. 4y!ecoma#tia

• Occu&i!' o!$y i! ma$e#• I!c&ea#ed b&ea#t #i8e due to e0ce##ive

mamma&y '$a!d deve$opme!t

• Mo#t commo! i! ci&&%o#i#• Fai$u&e to i!activate ci&cu$ati!' e#t&o'e!



@. Spide& NeviA!'ioma

• A -e&y &ed va#cu$a& $e##io! it% a!e$evated ce!t&a$ body a!d a#u&&ou!di!' Gu#%

• Mo#t commo! i! ace6 !ec56 a!dc%e#t

• Re$ated it% ci&&%o#i# a!d%ype&e#t&o'e!emia (p&e'!a!cy,



. /a$ma& E&yt%ema

• ;oca$ va#odi$atatio! a$o!' pa$ma& #ide

• Mo#t commo! i! ci&&%o#i#

• Mec%a!i#m i# u!5!o!



). A#cite#

• Accumu$atio! o Guid i! abdomi!a$ cavity• Due to dec&ea#e o o#motic p&e##u&e

(%ypoa$bumi!, o& i!c&ea#e o %yd&o7#tatic

p&e##u&e (po&ta$ %ype&te!#io!,• Si'!# du$$!e## i! bot% Ga!56 #%iti!'

du$$!e##6 u!du$atio!• No!#peci-c #i'!

• Mo#t commo! i! ci&&%o#i#6 'y!aeco$o'icdi#.6 #eve&e di#ea#e#6 pe&ito!ea$tube&cu$ou#6 &e!a$ a!d %ea&t p&ob$em



Ascites

ascites accumulation of fluid in the abdominal cavity







. /ai! pa$patio!

• Depe!d o! top%o'&ap%ic• Type#: Mu&p%y"# #i'!6 ;udi'"# #i'!6

<BA pe&cu##io! pai!6 epi'a#t&ic pai!6

Mc 3u&t!ey"# pai!6 dea!#e mu#cu$a&6#up&apubic pai!



. 1epatome'a$y

• 1epatic e!$a&'eme!t #ubco#ta$

• <o!-&med by pa$patio!6 pe&cu##io!6a!d #o!o'&ap%ic

• Due to #y#temic o& %epatic p&ob$em#

• Impo&ta!t t%i!'# #i8e6 co!#i#te!cy6

a!d pai!

liver enlarement "ortal hy"ertension



liver enlarement! "ortal hy"ertension



LI#ER SP$%

PERCUSSI&%

P$LP$'I&%

PERCUSSI&%

SCR$'CH 'ES'

%L ( )*+), CM

MCL

*+, CM -URI%.

I%SPIR$'I&% $%-

E/PIR$'I&%

C&P-

LI#ER SP$% M$0 #$R0 BE'1EE%

&BSER#ERS -EPE%-I%. UP&%

1HERE 'HE MCL IS -E'ERMI%E-

2$M$ )3345*6)7)893+)8:9



P$LP$'I&%

;LE/ <%EES $%- HIPS I; P&SSIBLE

BE.I% L&1 &% $B-&MI%$L 1$LL $%- M&#E H$%- CEPH$L$-! H$#EP$'IE%' '$<E $ -EEP BRE$'H

%&'E C&%SIS'E%C0 =%&-ULES! SM&&'H> $%- C&%'&UR I; 'HE LI#ER

E-.E IS ;EL'

%&'E I; 'HERE IS $%0 P$I% 1I'H P$LP$'I&%

$USCUL'$'E M&SB0?S .UI-E '& 'HE PH0SIC$L E/$MI%$'I&%! ,R- E-@ )339



=*. Sp$e!ome'a$y

• E!$a&'eme!t o #p$ee! be$o o a&cu#co#tae

• Due to i!ectio!6 t&auma6 po&ta$

%ype&te!#io!6 !eop$a#tic6%emato$o'ic di#o&de&#

• <o!-&med by pa$patio! a!d

#o!o'&ap%

$ i



==. Ma## pa$patio!

• Depe!d o! topo'&ap%ic (#imi$a& toabdomi!a$ pai!,

• Impo&ta!t t%i!'# #i8e6 co!#i#te!cy6mobi$ity6 a!d pai!

• <o!-&med by #o!o'&ap%6 &adio'&ap%6a!d e!do#copy



=>. F$appi!' T&emo&

• /ato'!omo!i# #i'! o e!cep%a$opat%y%epatic

• T&emo& o &i#t joi!t ate& u$$e0te!#io!



=?. /itti!' Edema

• Accumu$atio! o Guid i! #ubcuti#e#pecia$$y i! p$a!ta& pedi#

• Due to %epatic6 &e!a$6 %ea&t6ma$!ut&itio!6 b$ood ve##e$6 a!d#y#temic i!Gammatio!

<a#e Simu$atio!



<a#e Simu$atio!• A you!' $ady6 ma&&ied6 ?> yo6 came to %o#pita$

it% c%ie comp$ai!t o epi'a#t&ic pai! $oca$i8ed• %at ue#tio!# #%ou$d you a#5 to t%i# patie!tH

• T%i# $ady %ave a eve& #i!ce = ee5# a'o6

abdomi!a$ di#te!tio! i! epi'a#t&ic6vomitu#6 %i#to&y o b$oody dia&%ea6 !o%i#to&y o dy#pep#ia beo&e

• %at e0ami!atio!# #%ou$d you pe&o&m tot%i# patie!t#H



• F&om e0ami!atio!6 t%e&e a&e icte&ic6 pai!

a!d pa$pab$e ma## i! epi'a#t&ic6 da&5 teaco$o& u&i!e6 !o c$ey7co$o& #too$6 !odea!#e mu#cu$a&

• %at o&5i!' dia'!o#tic a!d die&e!tia$dia'!o#tic a&e po##ib$e i! t%i# patie!tH



• T%e o&5i!' di'!o#tic i! t%i# patie!t i#$et $obe %epatic abce##

• T%e die&e!tia$ dia'!o#tic a&e

pa!c&eatic !eop$a#m6 'a#t&ic ma##6p#eudocy#t o pa!c&ea#6 $et $obe%epatoma6 co$o! ma##6 $ymp%oma6ao&tic a!eu&i#m.

• %at a&e !e0t e0ami!atio!# you#u''e#ted to co!-&m a dia'!o#tic H

• %at i# t%e t&eatme!t H



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01 - Signs and Symptoms of Git Disorders