By V. I. Sreenivas M.D., F.R.C.S. (Edin.), F.A.C.S. (auth.)
The acute stomach usually perplexes the professional in addition to the younger doctor. There are few components in drugs during which Hippocrates' aphorism-the paintings is lengthy, existence is brief, determination tricky, and hold up perilous-is extra acceptable than right here. Too usually the harried health practitioner fails to hear the sufferer who's making an attempt desperately to indicate the prognosis. the importance of varied forms and site of soreness usually are missed by way of the physician. actual findings are stimulated through adventure; the presence or absence of tenderness or a mass might be replied in completely other ways via quite a few observers. simply because good evidence usually are missing, makes an attempt to unravel diagnostic dilemmas by way of computing device research or by way of algorithms usually are not more likely to be triumphant. thankfully, within the nice majority of circumstances, strange and hard diagnostic techniques should not worthwhile for the id of the intense stomach and of the foremost disorder. Astute medical judgment has to be dependent essentially upon cautious realization to the pa tient's phrases and particular observation.
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Additional info for Acute Disorders of the Abdomen: Diagnosis and Treatment
In the male this sac is 52 Acute Peritonitis completely closed, but in the female it communicates with the exterior through the fallopian tubes. Outside the peritoneum, but in close contact with it, is a rich network of capillaries and lymphatics through which all fluid exchange between the peritoneum and the intravascular compartment takes place. Under normal conditions only a small amount of fluid is present, which allows for easy gliding movements of the viscera. A discussion of peritoneal innervation is warranted, since the manifestations of peritonitis are modified by differences in nerve supply.
Discharge from vagina and tenderness in the region of Bartholin glands should be noted. Tenderness elicited on pelvic examination may be due to salpingitis, pelvic appendicitis, or torsion of an ovarian cyst. Movement of the uterus in the presence of pelvic peritonitis is painful. As in rectal examination, pelvic masses must be examined bimanually for more accurate delineation. 5 Imaging Procedures X-Ray Studies ABDOMEN Of the various imaging procedures available for the examination of patients with an acute abdomen, plain X rays of the abdomen usually are readily obtainable and provide significant information within a short period.
Position of the Diaphragm . Both thoracic and abdom- inal conditions can change the normal position of the diaphragm. With inflammatory conditions of the abdomen, the abdominal muscles are splinted and the movements of the diaphragm are restricted. Collapsed lung and subdiaphragmatic abscess result in elevation of the diaphragm on the affected side. Abnormal Gas Pattern. In the newborn infant gas is normally present in the stomach, and progresses distally to fill the entire gastrointestinal tract within 12-24 hours after birth .
Acute Disorders of the Abdomen: Diagnosis and Treatment by V. I. Sreenivas M.D., F.R.C.S. (Edin.), F.A.C.S. (auth.)