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Management of Abdominal Distension and Bloating - Treatment Algorithm

Definitions
Pathophysiology
Organic/Pathologic Etiologies:
 • Small Intestinal Bowel Overgrowth (SIBO)
Management of Abdominal ... and Bloating - Treatment ... Obstruction • Ascites ... EmoryGastroHep #Abdominal ... Distension #Bloating #Management
Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 • Defect in fetal free fatty acid metabolism products →
nausea, vomiting, abdominal ... develops (DIC, ascites ... Antithrombin Ill • Ultrasound ... Intrahepatic Cholestasis Management ... obgyn #diagnosis #management
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Albumin for Management ... ) - 8g per liter ... of ascites removed ... #Indications #Management ... #Cirrhosis #treatment
Cirrhosis, ascites, edematous gallbladder wall and a gallstone on Abdominal Ultrasound - POCUS 

Dr. J. Christian
Cirrhosis, ascites ... a gallstone on Abdominal ... Ultrasound - POCUS ... #Cirrhosis #Liver ... #Ultrasound #POCUS
Approach to the Hospitalized Patient with Cirrhosis
1) Recognize and Manage Decompensation
 • Ascites
 • Variceal Bleeding
Decompensation • Ascites ... Portosystemic Shunt • Liver ... Cirrhosis #diagnosis #treatment ... #management
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Insufficiency, Liver ... Severe auto-PEEP, Abdominal ... Dehydration Shock Treatment ... criticalcare #algorithm #treatment ... #management
Spontaneous Bacterial Peritonitis
DIAGNOSTICS
Paracentesis: 
 • Calculate absolute PMN count (total WBC x PMN %)
 • Correct
by inoculating ascitic ... signs (fever, abdominal ... dL and advanced liver ... SBP #diagnosis #management ... #prophylaxis #treatment
Pancreatitis management checklist 
Evaluation to guide etiology & management 
 - RUQ ultrasound 
 - Calcium
Pancreatitis management ... guide etiology & management ... - RUQ ultrasound ... Triglyceride level - Liver ... increase the risk of abdominal
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
irrigation • Management ... heart failure, liver ... Postoperative abdominal ... distention • Abdominal ... Tolvaptan) • Treatment
Emphysematous Cystitis
Epidemiology:
 • Usually middle-aged diabetic women
 • Other RF: neurogenic bladder, urinary tract outlet obstruction,
Abdominal or flank ... consider KUB or abdominal ... ultrasound as initial ... also important Management ... data • Early treatment