Large bowel obstruction Clinical features of large bowel obstruction The typical clinical features are: _ Abdominal pain due to distension and colic. _ Abdominal distension due to retention of faeces and flatus.
Small bowel obstruction Clinical features Classic presentations of small bowel obstruction include: _ crampy abdominal pain _ nausea and vomiting _ abdominal distension _ constipation.
Portal hypertension Clinical features The major clinical differentiation in patients with portal hypertension is the presence of underlying chronic hepatocellular liver disease and the detection of complications.
Cystic tumours Cystic tumours are quite rare lesions of the pancreas, representing 1% of malignant neoplasms of the pancreas. Histologically, they range from benign tumours of adenomatous appearance to cystadenocarcinomas.
Chronic pancreatitis Chronic pancreatitis is a fibrotic disease of the pancreas that is characterised by recurrent episodes of abdominal pain, and gastrointestinal symptoms and signs of malabsorption. In some patients, involvement of the islet cells also results in diabetes.
Diseases of the pancreas- Acute pancreatitis Clinical presentation Acute pancreatitis is characterized by an acute episode of epigastric to central abdominal pain, usually of rapid onset. The pain often radiates into the middle of the back. In some instances the patient may complain of vomiting; however, this is not a […]
Biliary Ascariasis Clinical features They induce mechanical obstruction of the biliary tree. Cholangitis, empyema of the gall bladder and multiple liver abscesses may occur as a result of secondary infection.
Clonorchis sinensis Clinical features The classic symptoms associated with clonorchis infestation are recurrent pyogenic cholangitis. There are recurrent attacks of right upper quadrant pain, jaundice and pyrexia. Examination may reveal tender hepatomegaly and splenomegaly if portal hypertension exists.
Liver fluke disease Infestations of clinical importance include those by Fasciola hepatica, Clonorchis sinensis and Ascaris lumbricoides. These parasites are trematodes and undergo both sexual (definitive host) and asexual (intermediatehost) reproduction.
Alveolar echinococcus Clinical features Early symptoms are usually non-specific and vague. The most common initial presentation is mild right upper quadrant pain.
Hydatid disease There are two forms of hydatid disease, the most common being Echinococcus granulosus, which causes cystic hydatid disease. Echinococcus alveolaris is a much rarer form and is characterized by an infiltrative pattern of liver involvement.
Parasitic infections Amoebic liver abscesses Clinical features The onset of the disease may be sudden or gradual. Right upper quadrant pain associated with general malaise and weight loss is the most common symptoms on presentation.
Liver infections Bacterial infections – Phylogenic abscess Clinical presentation and diagnosis The most common presenting symptoms include pyrexia and rigours associated with right upper quadrant pain, general malaise and anorexia. Examination may reveal tender hepatomegaly. A pleural effusion may be present. Occasionally, hypotension and cardiovascular collapse may be the presenting symptoms.
Liver Infections Parasitic infections- Amoebic liver abscesses
Infestations of clinical importance include those by Fasciola hepatica, Clonorchis sinensis and Ascaris lumbricoides.These parasites are trematodes and undergo both sexual (definitive host) and asexual (intermediate host) reproduction.
Gastric GIST Gastrointestinal stromal tumours were until the last decade described as leiomyomas or leiomyosarcomas and it is only with advances in molecular biology that this particular tumour has been recognized as a discrete entity.
Gastric lymphoma Lymphoma of the stomach accounts for 2–5% of all gastric neoplasms. In general they are of B cell origin although T cell lymphomas do occur. The commonest gastric lymphoma arises from mucosa associated lymphoid tissue (MALT) rather than lymph nodes. The occurrence of MALT in the stomach […]
Zollinger–Ellison syndrome This is a rare disease caused by overproduction of gastrin by G cell tumours of the pancreas or the duodenum.
Fractures and dislocations A fracture is a loss in the normal continuity of bone following the application of a direct or indirect force to that bone. A fracture may involve a part or the entire circumference of the cortex. CLINICAL PRESENTATION All fractures are painful. There is normally a history […]
INTRODUCTION Peptic ulcer is a common condition. Ten per cent of the population suffers from it at some time or another. The incidence and severity of peptic ulcer disease are decreasing in the Western world but they are increasing in developing countries. Because of the widespread use of non-steroidal anti-inflammatory […]
