Abdominal Examination (Part 1)...ppt.pptx

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1. Abdominal Examination (Part one) Raika Jamali M.D. Gastroenterologist and hepatologist Sina hospital Tehran University of Medical Sciences

2. Draping the patient

3. Inspection Check the skin of abdomen: Is it yellowish? Consider jaundice Is it hypo or hyper pigmentation? Consider vitiligo Is there any silver or purple strea? Consider weight loss or Cushing syndrome Is there any ecchymosis in flanks or periumbilical areas? Consider intraperitoneal hemorrhage (hemorrhagic pancreatitis or spleen rupture) Is there any incision of previous surgery? Is there any neurofibroma? Consider neurofibromatosis Is there any excoriation? Consider allergy, renal failure or cholestatic disorder

4. Vitiligo

5. Purple striae

6. Purple striae

7. Silver striae

8. Echymosis

9. Surgical incisions

10. Neurofibroma

11. Check for the subcutaneous vascular pattern: Is there any parallel or radial collateral veins? Consider IVC or portal vein obstruction

12. Caput medusae

13. IVC obstruction

14. Check for the shape of abdomen: Is there any mass? Is it fixed in respiration? Consider retroperitoneal mass Does it move with respiration? Consider hepatic or splenic mass Is there any mass with pulsation? Consider aneurysm of aorta Is the abdomen scaphoid? Consider diaphragmatic disorders Is there any hernia? Consider umbilical, incisional or midline hernia Is there any mass in periumbilical area? Lymph nodes (gastric cancer metastasis) Is there any swelling in flanks? Consider chronic ascites Is there any migratory mass? Consider intussusception

15. Abdominal mass

16. Distended gallbladder

17. Obese abdomen

18. Hepatosplenomegaly

19. Abdominal aorta aneurysm

20. Scaphoid abdomen

21. Abdominal hernias

22. Periumbilical lymph node

23. Ascites