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ABDOMEN SEMIOLOGY.
PARACLINICAL FINDINGS
I. SUBJECTIVE CLINICAL FEATURES
reflex manifestation
is present in almost all syndroms of ASA
initial alimentary
eventually bilious fecaloid
soon upper obstruction
time of onset
late lower obstruction
3. Stop of intestinal transit for stool and gases
mechanical obstacle (volvulus, tumor, invagination)
functional reflux peritonitis
4. Hiccup
reveals severe evolution of a peritoneal process.
II. GENERAL FEATURES
1. Fever
2. Shock reflex (due the pain)
- pallor
- cold sweat
- circulatory disorders
toxical-septic
- terous faccies
- dry tongue
eyes plugged in the eye socket
3. Respiratory disorders tachypneea
superficial breathing
III. Objective clinical manifestations
1. Inspection
peritontis terous facies
- dry skin
- immobile patient
- immobile abdomen towards
respiratory movements of the chest
intestinal obstruction protuberant abdomen
- intestinal peristaltics
are
sometimes visible
2. Percussion disappearance of flatteness in the
pre-hepatic area (in perforation)
3. Auscultation no peristaltic in evolutive
peritonitis
hydroaeric noiser hiperperistaltics
in occlusion
4. Digital rectal examination (DRE)
tumors
IDH
empty rectal ampul (i.o.)
foreign objects
tension of Douglas bottom bag
5. Digital vaginal examination (DVE)
organ torsion
ectopic pregnancy
IV. PARACLINICS
1. Ht. significant after 6-12h trow onset of bleeding
2. Amylase
3. WBC
4. RADIOLOGY
a. Native (no contrast substance)
- standing
- dorsal R / L decubitus
- pneumoperitoneum
- hydroaeric levels central (small bowel)
peripheric (organ
tube tipe in large
bowel
obstruction)
b. Rx pelvis
kidney
chest
c. Selective arteriography
d. Urography
e. Abdominal punction
f. Ultrasound
g. Diagnostic laparoscopy
h. CT
i. RMI