Professional Documents
Culture Documents
Dr.Shaesta.Tabassum
Historical Elements
O- onset
P-provocation /palliation
Q- quality/quantity
R- region/radiation
S- severity/scale
T- timing/time of onset
Physical Exam
General Appearance and Vitals
Abdominal exam
-Inspection (scars, masses, ecchymosis,
distention)
-Auscultation (bowel sounds, bruits),
-Percussion (organomegaly, dullness)
-Palpation (tenderness, guarding, rebound,
referred pain, masses)
-Don't forget GU, Rectal and Pelvic
Visceral Pain
Disadvantages:
Only useful in certain conditions – otherwise
low yield, difficult to position sick patients.
Radiology: Plain Films
When are they useful?
Obstruction/Ileus
Volvulus (cecal and sigmoid)
Free air
Radiopaque foreign bodies
Constipation?
Plain Films: Small bowel obstruction
Cecal Volvulus and Sigmoid Volvulus
Pneumoperitoneum
Iron Overdose:
Remember the radiopaque
foreign bodies mneumonic:
BAT CHIPS:
Barium
Antihistamines
Tricyclic antidepressants
Chloral hydrate, calcium,
cocaine
Heavy metals
Iodine
Phenothiazine, potassium
Slow-release (enteric
coated)
Radiology: Ultrasound
Advantages: Can be done at bedside, easy to
learn, repeatable, no radiation, cheap, can be
used in pregnancy, patient does not need to
leave the department