DISEASE

SYMPTOMS /PATHOLOGY S EVERE PAIN IN THE UPPER LEFT ABDOMEN RADIATING TO THE BACK . F EVER, NAUSEA, VOMITING . LARGE VOLUMES OF EXUDATE IN ABDOMINAL CABITY. H YPOVOLEMIA -> DECREASE IN BP

CAUSES /RISK F ACTORS

DIAGNOSIS

T REATMENT ICU: P AIN RELIEF F ASTING TO ALLOW THE PANCREAS TO REST I.V FLUIDS : REPLENISH ELECTROLYTES , COLLOID
SOLUTIONS

ACUTE PANCREATITIS:
S UDDEN SEVERE INFLAMMATORY REACTION TO AN ACUTE IRRITANT -> ACTIVATES AND RELEASES PANCREATIC ENZYMES .

A LCOHOL AND FATTY FOODS .

LABORATORY TEST : E LEVATED SERUM AMYLASE E LEVATED SERUM LIPASE

A NTIBIOTICS A BDOMINAL PAIN CAUSED BY STONES LODGED IN THE CYSTIC OR COMMON

BILE DUCT

GALLSTONE
C HOLESTEROL : MOST COMMON . BILE SUPERSATURATED WITH CHOLESTEROL MICROSTONES . P IGMENTED : INCREASED LEVELS OF BILIRUBIN .

A CCOMPANIED BY CHOLECYSTITIS JAUNDICE (INDICATES STONE IN BILE DUCT ) V IRAL : CAN BY ASYMPTOMATIC , OR ACUTE , CHRONIC (POSSIBLE PROGRESSION TO CIRRHOSIS ), FULMINATING DISEASE , RAPID ONSET OF LIVER FAILURE . P RODOMAL : F ATIGUE, SEVERE ANOREXIA , ABDOMINAL PAIN ON THE RIGHT SIDE , CHILLS , DEVER , MUSCLE / JOINT PAIN , NAUSEA , DIARRHOEA / CONSTIPATION JAUNDICE : SEVERE PRURITIS AND LIVER TENDERNESS . I NCREASED BILIRUBIN . CONVALESCENT : INC . SENSE OF WELL - BEING LIVER INFLAMMATION ( EXCESSIVE ALCOHOL INTAKE)

OBESITY, MIDDLE- AGE, FEMALE

H ISTORY , PHYSICAL EXAMINATION , B

ULTRASOUND

A NTIBIOTICS P AIN RELIEF LAPAROSCOPIC CHOLECYSTECTOMY

INFECTIOUS /VIRAL HEPATITIS

A, B, C, D, E E G H EP -A STAGES : PRODOMAL , JAUNDICE ,
CONVALESCENT

C ELL INJURY BY VIRAL HEP DUE TO DIRECT DAMAGE FROM VIRUS OR

INDIRECT DAMAGE BY OWN IMMUNE RESPONSES AGAINST VIRAL ANTIGEN .

NON-INFECTIOUS HEPATITIS
E G . A LCOHOLIC H EPATITIS

DRUGS , ALCOHOL , TOXINS ,

TUMOURS

OCCURS MOSTLY IN BINGE DRINKERS LONG TERM USE OF NSAIDS, H ELICOBACTER PYLORI INFECTION , ALCOHOL , SMOKING DUODENAL U LCER : CHRONIC INTERMITTENT PAIN (EPIGASTRIC AREA ). P AIN ON EMPTY STOMACH . P AIN - FOOD - RELIEF PATTERNS . BLEEDING CAUSE HEMATEMESIS OR MELENA . DUODENAL ULCER : OFTEN AFFECTS
THOSE WITH TYPE O BLOOD . M ORE COMMON IN MALES , 20-50 YRS OLD .

PEPTIC ULCER DISEASE:

UPPER GIT EXPOSED TO ACID - PEPSIN SECRETIONS IN THE LOWER OESOPHAGUS , STOMACH OR DUODENUM ULCERATION OF THE MUCOSAL LINING . A CUTE/ CHRONIC , SUPERFICIAL / TRUE DUODENAL G ASTRIC : ABNORMALITY THAT INCREASES PERMEABILITY OF THE GASTRIC MUCOASA TO H+.

BARIUM MEAL , ENDOSCOPY , UREA BREATH TEST FOR H.

PYLORI

T RIPLE THERAPY : ANTIBIOTICS / ACID SUPPRESSORS / STOMACH PROTECTORS

G ASTRIC U LCER ( STOMACH ): E PIGASTRIC PAIN IMMEDIATELY AFTER EATING . C HRONIC , MORE VOMITING AND WEIGHTLOSS THAN DUODENAL . C AN PROGRESS TO CANCER .

G ASTRIC U LCER OFTEN AFFECTS

THOSE WITH TYPE A BLOOD . M ORE COMMON IN THE 55-65 AGE GROUP , OCCURING EQUALLY IN MALES AND FEMALES .

GASTROESOPHAGEAL REFLUX
REFLUX OF CHYME FROM STOMACH TO OESOPHAGUS . MAY DEVELP INTO REFLUX ESOPHAGITIS INFLAM RESPONSE TO REPEATED EXPOSURE TO ACIDS / PEPSINS IN CHYME .

I NFLAMMATORY RESPONSES : OEDEMA, TISSUE FRAGILITY , EROSION , FIBROSIS AND THICKENING CAN DEVELOP . H EARTBURN , REGURGIATION OF ACID CHYME, UPPER ABDOMINAL PAIN IN 1 HOUR OF EATING .

I NCREASED ABDOMINAL PRESSURE: VOMITING , COUGHING , LIFTING , BENDING . DELAYED GASTRIC EMPTYING : PEPTIC ULCERS , NARROWING OF PYLORIC
SPHINCTER

C LINICAL S YMPTOMS , ENDOSCOPY , BARIUM MEAL

A NTACIDS NEUTRALISE GASTRIC CONTENTS S MOOTH MUSCLE STIMULANTS INCREASE RATE

OF GASTRIC EMPTYING

S URGERY NARROW GASTROESOPHAGEAL

SPHINCTER

SYMPTOMS/PATHOLOGY

CAUSE
I NFLAMMATORY BOWEL DISEASE AND INVASIVE BACTERIAL INFECTIONS .

DIAGNOSIS
RECURRENT SYMPTOMS OF AT LEAST 12 WKS ABDOMINAL PAIN WITH 2 OF THE THREE FEATURES : RELIEF WITH DEFECATION ONSET ASSOCIATED WITH CHANGE IN BOWEL
FREQUENCY

TREATMENT
MANAGE PSYCHO / PHYSIOLOGIC STRESS A DEQUATE FIBRE INTAKE , AVOID ALCOHOL , FATTY FOOD AND CAFFIENE , ANTISPASMODIC
AND ANTICHOLINERGIC DRUGS

IRRITABLE BOWEL SYNDROME

I NFLAMMATORY DAMAGE TO THE MUCOSA IMPAIRS ABSORPTIVE CAPCITY -> EXUDATION OF FLUID AND PROTEINS INTO THE LUMEN .

ONSET ASSOCIATED WITH A CHANGE IN FORM OF

STOOL

INFLAMMATORY BOWEL SYNDROME ULCERATIVE COLITIS

C HRONIC NON - SPECIFIC INFLAMMATORY CONDITION . ULCERATION OF COLONIC MUSCOSA (USUALLY IN COLON / RECTUM ) P INPOINT MUCOSAL HAEMORRHAGES AND PUS (STOOL CONTAINS BLOOD AND MUCOUS ) I NFLAMMATION CAUSES DIARRHOEA . A FFECTS LAST PART OF SMALL INTESTINE (ILEUM )/ LARGE INTESTINE . NUTRITIONAL DEFICENCIES

INFLAMMATORY BOWEL SYNDROME CROHNS DISEASE MALABSORPTION SYNDROME

T HE FAILURE OF INTESTINAL MUCOSA TO ABSORB DIGESTED NUTRIENTS . (U SUALLY RESULT OF MALDIGESTION .) S TEATORRHOEA DIARRHOEA DECREASED LIPID ABSORPTION DECREASED ABSORPTION OF FAT SOLUBLE
VITAMINS AND CHOLESTEROL

NIGHT BLINDNESS (V IT A DEF ) OSTEOPOROSIS , BONE PAIN (V IT D DEF ) S LOW HEALING , NERVE DAMAGE (VIT E DEF ) E ASY BRUISING , DECREASED CLOTTING (VIT K DEF ) DECREASED STEROID HORMONE SYNTH ( DEC . CHOLESTEROL .) F OUL SMELLING BULKY STOOL (STEATORRHOEA ) BACTERIA DIGEST EXTRA FAT FOR SOURCE OF FOOD .

P ANCREATIC I NSUFFICIENCY (CHRONIC PANCREATITIS , PANCREATIC CANCER , PANCREATIC CYSTIC FIBROSIS .) BILE SALT DEFICIENCY D ECREASE IN PRODUCTION / SECRETION OF BILE ADVANCED LIVER DISEASE , OBSTRUCTION OF THE COMMON BILE DUCT , INTESTINAL STASIS AND DISEASES OF ILEUM . RESULTS IN FAT MALABSORPTION.