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Summary Abdominal Core Conditions
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A condensed summary of the abdominal core conditions for the Leeds MBChB year 3 syllabus
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ABDOMINAL CORE CONDITIONS SUMMARYCondition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Mid-abdominal pain that
Appendix obstruction leads to Viral gastroenteritis;
shifts to RIF; McBurney’s
distention and an increase in diverticulitis; UTI;
Appendix lumen sign; anorexia; N&V Appendectomy Perforation;
intraluminal pressure; as this pressure intussusception;
obstruction from FBC; urinalysis; peritonitis;
Inflammation of the 15-50y/o exceeds venous pressure, venules Good if treated Low-fibre diet; Crohn’s disease;
Appendicitis appendix M>F and capillaries become thrombosed, promptly
faecolith, normal stool
smoking
Perforation may cause pregnancy test;
right-sided ureteric
+ IV Abx, IV appendicular mass/
or lymphoid hypotension, USS/CT abdomen fluids, analgesia, abscess; surgical
but arterioles remain open leading to stone; cholecystitis;
hyperplasia tachycardia, rigid anti-emetics wound infection
engorgement and congestion of the ectopic pregnancy;
abdomen, guarding,
appendix ovarian torsion; PID
absent bowel sounds
Architectural change in the liver
Total HTN (cirrhosis/
disrupts normal vascular pattern; Urgent USS; FBC; Bacterial peritonitis;
CCF); pericarditis;
Pathological blockage of portal venous outflow Good if a/w liver Alcohol; low- U&Es; LFTs; CRP; HCV; alcoholic haemoperitoneum;
myxoedema; Flank dullness; shifting
accumulation of causes blood flow resistance in the liver disease; protein diet; INR; serum ascites- hepatitis; nephrotic Identify and treat refractory ascites;
Ascites fluid within the Cirrhotic patients portal system; portal HTN increases poor if a/w hypoalbuminaemia hepatitis; cirrhosis; dullness; abdominal albumin gradient; syndrome; CHF; cause hepatorenal
(nephrotic syndrome); pain; SOB; distention
peritoneal cavity hydrostatic pressure in liver sinusoids malignancy cardiac disease CT/MRI; diagnostic pancreatitis syndrome; hepatic
malignancy; infection;
causing transudation of fluid into the paracentesis encephalopathy
pancreatitis
peritoneal cavity
Depends on Rectal bleeding; change Chemo-associated
Carcinoma of the Genetic and Local/radical
Arises from dysplastic adenomatous stage of Age; APC in bowel habit FBC; LFTs; U&Es; bone marrow
Carcinoma, epithelium of the environmental Haemorrhoids; anal excision;
Caucasian adults polyps (FAP); inactivation of tumour disease; 50% mutation; Lynch (particularly increased colonoscopy, suppression, GI
colon or rectum, components; Lynch fissure; diverticular radiotherapy;
colorectal M>F suppressors and DNA repair genes, have advanced syndrome; IBD; frequency or looser double-contrast symptoms, alopecia;
most commonly syndrome (HNPCC) disease; IBS; IBD chemotherapy;
and activation of oncogenes disease at obesity stools); rectal mass; barium enema; CT radio-associated
adenocarcinoma FHx; FAP monoclonal Ab
diagnosis anaemia faecal incontinence
FHx; pernicious Surgery;
Carcinoma of the Abdominal pain; weight Peptic ulcer Malnutrition; gastric
Loss of the tumour suppressor gene Good-to-very Consumption of anaemia; H. pylori; Biopsy gastroscopy; chemotherapy;
Carcinoma, stomach, most M>F (p53) and over-expression of some poor, depending smoked and salted diet low in fruit loss; lymphadenopathy endoscopic USS; disease; benign chemoradiation; obstruction; post-
gastric commonly (Virchow’s node); oesophageal operative gastro-
proto-oncogenes on stage foods; H. Pylori and vegetables; CT scan; CXR palliative
adenocarcinoma dysphagia stricture; achalasia paresis; GI bleeding
smoking gastrectomy
Obesity; low
Arises in the mucosa, then progresses Differs with histology: socioeconomic Biopsy OGD; FNA; Endoscopic
Carcinoma of the locally to invade submucosa and Devastating Pneumonia; post-
Developed SCC (tobacco, status; for SCC Weight loss; dysphagia; comprehensive resection;
Carcinoma, oesophagus; most countries muscular layers; large contribution without alcohol, HPV); (tobacco, alcohol, odynophagia; hiccups; metabolic profile; CT Benign stricture; chemotherapy; resection reflux;
oesophageal commonly from acetaldehyde (carcinogenic aggressive achalasia; BE oesophago-aortic
M>F adenocarcinoma FHx, HPV); for hoarseness; cough chest/abdomen, radiotherapy;
adenocarcinoma metabolite of alcohol), tobacco and treatment fistula; TOF
(GORD/BE, ↑BMI) adenocarcinoma endoscopic USS oesophagectomy
reflux disease (GORD/BE)
(GORD/BE, ↑BMI)
Progression from normal epithelium to Abdominal/ Chronic Resection; biliary Fistula; early delayed
invasive carcinoma follows a linear Smoking; FHx; Jaundice; non-specific endoscopic USS; pancreatitis; stenting; enzyme gastric emptying;
Carcinoma, Carcinoma of the Elderly progression a/w accumulation of Poor Age; smoking; genetic other hereditary upper abdominal pain; CT scan; LFTs; FBC; choledocholithiasis; replacement; cholangitis; duodenal
pancreatic pancreas component
genetic alterations; most common in cancer syndromes weight loss; anorexia cancer antigens; ampulla carcinoma; chemotherapy; obstruction; DVT/PE;
the head of the pancreas ERCP; MRCP cholangiocarcinoma radiotherapy haemorrhage
Bile stasis; ERCP; MRCP;
Adults-elderly, with RUQ/epigastric pain; Malignancy; bile
Presence of Gallstones block the CBD and bile Gallstones pass from pregnancy; OCP; FBC; LFTs; U&Es; laparoscopic Pancreatitis; surgical
Choledocholithiasis gallstones in the hyperlipidaemia cannot pass, so backs up into the liver Good if treated the gallbladder to obesity; sickle cell jaundice; pruritis; N&V; coagulation profile; duct stricture; cholecystectomy would infection;
(bile duct stones) and/or cholelithiasis promptly pale stools/dark urine pancreatitis;
CBD causing symptoms CBD spontaneously disease; cirrhosis; USS; MRCP with bile duct cholangitis
M<F (obstructive picture) cholecystitis
hyperlipidaemia exploration
Stones (usually High cholesterol and bilirubin within Age; pregnancy; Peptic ulcer Cholecystectomy
High cholesterol: FBC; U&Es; LFTs;
consisting of the gallbladder causes a chemical obesity; DM; rapid RUQ/epigastric pain; disease; gallbladder Cholecystitis,
Cholelithiasis cholesterol) that Adults imbalance in the bile that results in the Good following obesity; TPN; rapid weight loss; some tenderness on palpation; amylase/lipase; cancer; gallbladder + ERCP, cholangitis,
(gallstones) M<F cholecystectomy weight loss; some USS/CT abdomen;
develop in the development of tiny crystals that medications; FHx; nausea; jaundice polyps; non-biliary lithotripsy, biliary pancreatitis
gallbladder gradually grow into solid stones medications high cholesterol MRCP acute pancreatitis stenting
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