1. Hepatojugular reflux sign
When right heart failure causes hepatic congestion and swelling, the liver can be compressed with hands to make the jugular veins more distended. The most common causes are right ventricular insufficiency and congestion hepatitis.
2.Cullen’s sign
Also known as Coulomb’s sign, purple-blue ecchymosis on the skin around the umbilicus or lower abdominal wall is a sign of massive intra-abdominal bleeding, which is more common in retroperitoneal hemorrhage, acute hemorrhagic necrotizing pancreatitis, ruptured abdominal aortic aneurysm, etc.
3.Grey-Turner sign
When a patient develops acute pancreatitis, pancreatic juice overflows into the subcutaneous tissue space of the waist and flank, dissolving subcutaneous fat, and capillaries rupture and bleed, resulting in bluish-purple ecchymosis on the skin in these areas, which is called Grey-Turner’s sign.
4.Courvoisier sign
When cancer of the head of the pancreas compresses the common bile duct, or cancer of the middle and lower segments of the bile duct causes obstruction, obvious jaundice occurs. A swollen gall bladder that is cystic, non-tender, has a smooth surface and can be moved is palpable, which is called Courvoisier’s sign, also known as progressive obstruction of the common bile duct. levy.
5.Peritoneal irritation sign
The simultaneous presence of tenderness, rebound tenderness and abdominal muscle tension in the abdomen is called peritoneal irritation sign, also known as the peritonitis triad. It is a typical sign of peritonitis, especially the location of the primary lesion. The course of abdominal muscle tension depends on the cause and the patient’s condition. The general condition varies, and increased abdominal distension is an important sign of worsening condition.
6.Murphy’s sign
A positive Murphy sign is one of the important signs in the clinical diagnosis of acute cholecystitis. When palpating the gallbladder area under the right costal margin, the swollen gallbladder was touched and the patient was asked to inhale deeply. The swollen and inflamed gallbladder moved downward. The patient felt the pain intensified and suddenly held his breath.
7.Mcburney’s sign
Tenderness and rebound tenderness at McBurney’s point in the right lower abdomen (the junction of the umbilicus and the middle and outer 1/3 of the right anterior superior iliac spine) are common in acute appendicitis.
8.Charcot’s triad
Acute obstructive suppurative cholangitis typically presents with abdominal pain, chills, high fever, and jaundice, also known as Chaco’s triad.
1) Abdominal pain: Occurs under the xiphoid process and in the right upper quadrant, usually colic, with paroxysmal attacks or persistent pain with exacerbation of paroxysms, which can radiate to the right shoulder and back, accompanied by nausea and vomiting. It is often triggered after eating greasy food.
2) Chills and fever: After bile duct obstruction, the pressure within the bile duct increases, often resulting in secondary infection. Bacteria and toxins can flow back into the blood through the capillary bile ducts and hepatic sinusoids, resulting in biliary liver abscess, sepsis, septic shock, DIC, etc., generally manifests as dilatant fever, with body temperature as high as 39 to 40°C.
3) Jaundice: After stones block the bile duct, patients may develop dark yellow urine and yellow staining of the skin and sclera, and some patients may experience skin itching.
9.Reynolds (Renault) five signs
The stone incarceration is not relieved, the inflammation further aggravates, and the patient develops mental disorder and shock based on Charcot’s triad, which is called Raynaud’s pentalogy.
10.Kehr’s sign
Blood in the abdominal cavity stimulates the left diaphragm, causing left shoulder pain, which is common in splenic rupture.
11. Obturator sign (obturator internus muscle test)
The patient was in the supine position, with the right hip and thigh flexed and then passively rotated inward, causing right lower abdominal pain, which is seen in appendicitis (the appendix is close to the obturator internus muscle).
12. Rovsing’s sign (colon inflation test)
The patient is in a supine position, with his right hand compressing the left lower abdomen and his left hand squeezing the proximal colon, causing pain in the right lower abdomen, which is seen in appendicitis.
13.X-ray barium irritation sign
Barium shows signs of irritation in the diseased intestinal segment, with rapid emptying and poor filling, while filling is good in the upper and lower intestinal segments. This is called X-ray barium irritation sign, which is common in patients with ulcerative intestinal tuberculosis. .
14. Double halo sign/target sign
In the active stage of Crohn’s disease, the improved CT enterography (CTE) shows that the intestinal wall is significantly thickened, the intestinal mucosa is significantly enhanced, part of the intestinal wall is stratified, and the inner mucosal ring and outer serosa ring are significantly enhanced, showing a double halo. sign or target sign.
15. Wooden comb sign
In the active stage of Crohn’s disease, CT enterography (CTE) shows an increase in mesenteric blood vessels, correspondingly increased mesenteric fat density and blurring, and mesenteric lymph node enlargement, showing the “wooden comb sign”.
16. Enterogenic azotemia
After massive bleeding in the upper gastrointestinal tract, the digestion products of blood proteins are absorbed in the intestines, and the concentration of urea nitrogen in the blood may temporarily increase, which is called enterogenic azotemia.
17.Mallory-Weiss syndrome
The main clinical manifestation of this syndrome is sudden increase in intra-abdominal pressure due to severe nausea, vomiting and other reasons, which causes longitudinal tearing of the mucosa and submucosa of the distal cardiac cardia and esophagus, thereby causing upper gastrointestinal bleeding. The main manifestations are sudden Acute hematemesis, preceded by repeated retching or vomiting, is also called esophageal and cardia mucosal tear syndrome.
18. Zollinger-Ellison syndrome (gastrinoma, Zollinger-66Ellison syndrome)
It is a type of gastroenteropancreatic neuroendocrine tumor characterized by multiple ulcers, atypical locations, susceptibility to ulcer complications, and poor response to regular anti-ulcer drugs. Diarrhea, high gastric acid secretion, and elevated blood gastrin levels may occur. higher.
Gastrinomas are usually small, and about 80% are located within the “gastrinoma” triangle (i.e., the confluence of the gallbladder and common bile duct, the second and third parts of the duodenum, and the neck and body of the pancreas). Within the triangle formed by the junction), more than 50% of gastrinomas are malignant, and some patients have metastasized when discovered.
19. Dumping syndrome
After subtotal gastrectomy, due to the loss of the control function of the pylorus, the gastric contents are emptied too quickly, resulting in a series of clinical symptoms called dumping syndrome, which is more common in PII anastomosis. According to the time when symptoms appear after eating, it is divided into two types: early and late.
●Early dumping syndrome: Symptoms of temporary hypovolemia such as palpitations, cold sweats, fatigue, and pale complexion appear half an hour after eating. It is accompanied by nausea and vomiting, abdominal cramps, and diarrhea.
●Late dumping syndrome: occurs 2 to 4 hours after eating. The main symptoms are dizziness, pale complexion, cold sweat, fatigue, and rapid pulse. The mechanism is that after food enters the intestine, it stimulates a large amount of insulin secretion, which in turn leads to reactive hypoglycemia. It is also called hypoglycemia syndrome.
20. Absorptive dystrophy syndrome
It is a clinical syndrome in which nutrients are deficient due to dysfunction of the small intestine in digesting and absorbing nutrients, causing nutrients to be unable to be absorbed normally and excreted in the feces. Clinically, it often manifests as diarrhea, thin, heavy, greasy and other fat absorption symptoms, so it is also called steatorrhea.
21.P-J syndrome (pigmented polyposis syndrome, PJS)
It is a rare autosomal dominant tumor syndrome characterized by skin and mucosal pigmentation, multiple hamartomatous polyps in the gastrointestinal tract, and tumor susceptibility.
PJS occurs since childhood. As patients age, gastrointestinal polyps gradually increase and enlarge, causing various complications, such as intussusception, intestinal obstruction, gastrointestinal bleeding, cancer, malnutrition, and developmental retardation in children.
22. Abdominal compartment syndrome
The intra-abdominal pressure of a normal person is close to atmospheric pressure, 5 to 7 mmHg.
Intra-abdominal pressure ≥12 mmHg is intra-abdominal hypertension, and intra-abdominal pressure ≥20 mmHg accompanied by organ failure related to intra-abdominal hypertension is abdominal compartment syndrome (ACS).
Clinical manifestations: The patient has chest tightness, shortness of breath, difficulty breathing, and accelerated heart rate. Abdominal distension and high tension may be accompanied by abdominal pain, bowel sounds weakened or disappeared, etc. Hypercapnia (PaCO?>50 mmHg) and oliguria (urine output per hour <0.5 mL/kg) can occur in the early stage of ACS. Anuria, azotemia, respiratory failure and low cardiac output syndrome occur in the later stage.
23. Superior mesenteric artery syndrome
Also known as benign duodenal stasis and duodenal stasis, a series of symptoms caused by the abnormal position of the superior mesenteric artery compressing the horizontal segment of the duodenum, resulting in partial or complete obstruction of the duodenum.
It is more common in asthenic adult women. Hiccups, nausea, and vomiting are common. The prominent feature of this disease is that the symptoms are related to body position. When the supine position is used, the compression symptoms are aggravated, while when the prone position, knee-chest position, or left side position, the symptoms can be relieved. .
24. Blind loop syndrome
A syndrome of diarrhea, anemia, malabsorption and weight loss caused by stagnation of small intestinal contents and bacterial overgrowth in the intestinal lumen. It is mainly seen in the formation of blind loops or blind bags (i.e. intestinal loops) after gastrectomy and gastrointestinal anastomosis. And caused by stasis.
25. Short bowel syndrome
It means that after extensive small intestine resection or exclusion due to various reasons, the effective absorption area of the intestine is significantly reduced, and the remaining functional intestine cannot maintain the nutrition of the patient or the growth needs of the child, and symptoms such as diarrhea, acid-base/water/electrolyte disorders, and syndromes dominated by disorders of absorption and metabolism of various nutrients.
26. Hepatorenal syndrome
The main clinical manifestations are oliguria, anuria and azotemia.
The patient’s kidneys had no substantial lesions. Due to severe portal hypertension and splanchnic hyperdynamic circulation, the systemic blood flow was significantly reduced, and a variety of vasodilator substances such as prostaglandins, nitric oxide, glucagon, atrial natriuretic peptide, endotoxin, and Calcium gene-related peptides cannot be inactivated by the liver, causing the systemic vascular bed to dilate; a large amount of peritoneal fluid can cause a significant increase in intra-abdominal pressure, which can reduce renal blood flow, especially renal cortex hypoperfusion, leading to renal failure.
80% of patients with rapidly progressive disease die within about 2 weeks. The slowly progressive type is more common clinically, often presenting with refractory abdominal effusion and a slow course of renal failure.
27. Hepatopulmonary syndrome
On the basis of liver cirrhosis, after excluding primary cardiopulmonary diseases, dyspnea and signs of hypoxia such as cyanosis and clubbing of the fingers (toes) appear, which are related to intrapulmonary vasodilation and arterial blood oxygenation dysfunction, and the prognosis is poor.
28.Mirizzi syndrome
Gallbladder neck or cystic duct stone impaction, or combined with gallbladder inflammation, pressure
It occurs by forcing or affecting the common hepatic duct, causing surrounding tissue proliferation, inflammation or stenosis of the common hepatic duct, and clinically manifests as a series of clinical syndromes characterized by obstructive jaundice, biliary colic or cholangitis.
The anatomical basis for its formation is that the cystic duct and common hepatic duct are too long together or the confluence position of the cystic duct and common hepatic duct is too low.
29.Budd-Chiari syndrome
Budd-Chiari syndrome, also known as Budd-Chiari syndrome, refers to a group of portal hypertension or portal and inferior vena cava hypertension caused by obstruction of the hepatic vein or the inferior vena cava above its opening. disease.
30.Caroli syndrome
Congenital cystic dilation of intrahepatic bile ducts. The mechanism is unclear. It may be similar to choledochal cyst. The incidence of cholangiocarcinoma is greater than that of the general population. The early clinical manifestations are hepatomegaly and abdominal pain, mostly like biliary colic, complicated by bacterial bile duct disease. Fever and intermittent jaundice occur during inflammation, and the degree of jaundice is generally mild.
31. Puborectal syndrome
It is a defecation disorder caused by obstruction of the pelvic floor outlet due to spasm or hypertrophy of the puborectalis muscles.
32. Pelvic floor syndrome
It refers to a group of syndromes caused by neuromuscular abnormalities in the pelvic floor structures including the rectum, levator ani muscle, and external anal sphincter. The main clinical manifestations are difficulty in defecation or incontinence, as well as pelvic floor pressure and pain. These dysfunctions sometimes include difficulty defecation, and sometimes fecal incontinence. In severe cases, they are extremely painful.
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Post time: Sep-06-2024