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Differential Diagnosis of Abdominal Distention
Mechanical Obstruction
•pneumatosis intestinalis, annular pancreas, Hirschsprung’s
disease, intussusception, meconium
• Volvulus
• Stenosis at surgical anastomosis, radiation stenosis
• Pregnancy
• Other: parasites, superior mesenteric artery (SMA) syndrome,
• Neoplasm (intraluminal, extraluminal)
• Inflammatory bowel disease (IBD)
• Infection (intra-abdominal abscess, diverticulitis)
• Hernias
• Hematoma
• Gastric outlet obstruction
• Gallstones
• Foreign body, bezoars
• Fecaliths
• Adhesions, endometriosis
Non Mechanical Obstruction
• Vascular insufficiency (thrombosis, embolism)
• Trauma
• Severe pain
• Retroperitoneal irritation (renal colic, neoplasms, infections, hemorrhage)
• Peritoneal inflammation
• Pain medications
• Metabolic/toxic abnormalities (hypokalemia, uremia, lead poisoning)
• Mechanical ventilation
• Intra-abdominal infection
• Extra-abdominal infection (sepsis, pneumonia, empyema, osteomyelitis of spine)
• Excessive intraluminal gas
• Chemical irritation (perforated ulcer, bile, pancreatitis)
Mechanical Obstruction
•pneumatosis intestinalis, annular pancreas, Hirschsprung’s
disease, intussusception, meconium
• Volvulus
• Stenosis at surgical anastomosis, radiation stenosis
• Pregnancy
• Other: parasites, superior mesenteric artery (SMA) syndrome,
• Neoplasm (intraluminal, extraluminal)
• Inflammatory bowel disease (IBD)
• Infection (intra-abdominal abscess, diverticulitis)
• Hernias
• Hematoma
• Gastric outlet obstruction
• Gallstones
• Foreign body, bezoars
• Fecaliths
• Adhesions, endometriosis
Non Mechanical Obstruction
• Vascular insufficiency (thrombosis, embolism)
• Trauma
• Severe pain
• Retroperitoneal irritation (renal colic, neoplasms, infections, hemorrhage)
• Peritoneal inflammation
• Pain medications
• Metabolic/toxic abnormalities (hypokalemia, uremia, lead poisoning)
• Mechanical ventilation
• Intra-abdominal infection
• Extra-abdominal infection (sepsis, pneumonia, empyema, osteomyelitis of spine)
• Excessive intraluminal gas
• Chemical irritation (perforated ulcer, bile, pancreatitis)
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