DR SIMON ATTARD MONTALTO
History
A. General
age, sex, temperature, health
B. Pain
onset, frequency, progress
precipitants, influencing factors
where and radiation
nature
severity
C. Associations
frequency, dysuria, haematuria
vomiting (?bile), bowel habit
abdo distention
appetite
headaches, drowsiness
family history
psychosocial history
dietary history
drug history
Examination:
A. General:
unwell, anaemia, bruises
dehydration
rashes
shocked (BP, pulse, perfusion)
respiratory status
B. Specific:
distention, swelling
scars, bruises, fistulae
tenderness, guarding, rebound
bowel sounds
organomegaly, masses
herniae, gonads
perineum (PR)
vomitus, stool, urine
C. Others:
chromosomal abnormality
ketoacidosis
lymphadenopathy
inborn error of metabolism
Differential Diagnosis
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Neonates |
Infants |
Children |
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Infective: |
septicaemia |
gastroenteritis |
gastroenteritis |
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hepatitis |
hepatitis |
hepatitis |
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abscess |
abscess |
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pneumonia |
infectious mononucleosis |
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Surgical: |
atresias |
adhesions |
adhesions |
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malrotation |
malrotation |
appendicitis |
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volvulus |
volvulus |
Meckel's diverticulum |
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meconium. ileus |
intussusception |
intussusception |
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Trauma: |
birth injury |
accidental/NAI |
accidental/NAI/violence |
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Urological: |
UTI |
UTI |
UTI |
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cong anomaly |
cong anomaly |
stones |
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Inflammatory: |
NEC |
IBD |
IBD |
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ischaemia |
ischaemia |
ischaemia |
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HSP |
HSP |
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mesenteric adenitis |
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abdominal. migraine |
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(pancreatitis)* |
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Tumours: |
teratoma |
neuroblastoma |
neuroblastoma |
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haematological |
Wilms |
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leukaemia, NHL |
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Others: |
Constipation |
constipation |
constipation |
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drugs |
drugs |
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accidental ingestion |
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ketoacidosis |
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(inborn error of met.)* |
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(porrphyria)* |
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Psychogenic: |
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Munchausen BP |
psychosomatic |
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Munchausen by proxy |
Legend:UTI=urinary tract infection; NEC=necrotising enterocolitis; IBD=inflammatory bowel disease; HSP=Henoch Schonlein purpura,