DOCSLIB.ORG

Symptomatic Management of Primary Acute Gastroenteritis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Symptomatic Management of Primary Acute Gastroenteritis Peer Reviewed SYMPTOMATIC MANAGEMENT OF PRIMARY ACUTE GASTROENTERITIS Symptomatic Management of Primary Acute Gastroenteritis Yuri Lawrence, DVM, MA, MS, Diplomate ACVIM (Small Animal Internal Medicine), and Jonathan Lidbury, BVMS, MRCVS, Diplomate ACVIM (Small Animal Internal Medicine) & ECVIM (Companion Animal) Texas A&M University Acute gastroenteritis is a term used to describe a TABLE 1. syndrome characterized by the sudden onset of Selected Causes of Secondary Acute vomiting and/or diarrhea caused by gastrointestinal Gastroenteritis mucosal inflammation. • Prototheca species Algal This diagnosis is seldom confirmed by Bacterial • Campylobacter species histopathologic evaluation; instead, it is based on • Clostridia species a consistent clinical presentation and exclusion of • Escherichia coli • Neorickettsia helminthoeca other potential causes for the patient’s clinical signs. • Salmonella species Mucosal inflammation is assumed, but not proven Drugs • Antibiotics to be present. Therefore, acute gastroenteropathy is • Cyclosporine perhaps a more appropriate name. • Glucocorticoids • Mycophenolate • Nonsteroidal anti-inflammatory drugs DIAGNOSTIC EVALUATION Acute gastroenteritis is among many potential Parasitic • Ancylostoma caninum • Ollulanus tricuspis causes of acute vomiting and diarrhea (Table 1). • Physaloptera species However, in many cases, the cause of primary acute • Strongyloides species gastroenteritis is not determined. Rapid resolution • Toxoascaris leonina of clinical signs often means that extensive diagnostic • Toxocara canis evaluation is unnecessary. Protozoal • Cryptosporidium parvum • Giardia species • Isospora canis Physical Examination No specific physical examination findings are Systemic • Bacterial cholecystitis disease • Gallbladder mucocele pathognomonic for acute gastroenteritis, and some • Gastric dilatation and volvulus dogs do not have any significant abnormalities. • Hepatic disease Findings consistent with acute gastroenteritis include • Hypoadrenocorticism • Pancreatitis lethargy, pytalism, and abdominal discomfort. • Pyometra It is particularly important to assess the patient’s • Renal disease hydration status and palpate the abdomen carefully, • Sepsis checking for physical examination findings that • Septic peritonitis • Splenic torsion would warrant further diagnostic evaluation (ie, abnormalities that suggest the problem is more Toxins • Chocolate • Lead significant than straightforward acute gastroenteritis) • Mushrooms (Table 2). Findings that indicate dehydration • Organophosphates include dry oral mucous membranes, prolonged • Xylitol • Zinc capillary refill time, and prolonged skin tent. Tachycardia, weak pulses, and cool extremities are Viral • Canine coronavirus • Canine parvovirus consistent with hypovolemia. • Feline immunodeficiency virus • Feline leukemia virus Laboratory Analysis • Feline parvovirus (panleucopenia virus) Patients with a normal physical examination and 46 TODAY’s VeTERINARY PRACTICE | November/December 2015 | tvpjournal.com SyMPTOMATIC MANAGEMENT OF PRIMARy ACUTE GASTROENTERITIS Peer Reviewed mild clinical signs may not require laboratory testing on initial presentation. However, laboratory testing may be indicated to rule out extra-gastrointestinal causes of acute gastrointestinal signs, such as acute kidney injury, acute hepatitis, and pancreatitis, and metabolic complications of acute gastroenteritis, such as electrolyte and acid base abnormalities. When performed, laboratory testing should include a complete blood count, serum biochemical profi le, and urinalysis. Measurement of serum canine pancreas-specifi c lipase concentration may also be indicated to diagnose pancreatitis, and baseline serum cortisol concentration may be measured in order to exclude hypoadrenocorticism. Additional laboratory testing for infectious disease should be considered based on geographic location and FIGURE 1. Gastric nematode presumed to be signalment. For example, serology assists in diagnosis Physaloptera rara visualized during gastroscopy. of Salmon poisoning disease in the Pacifi c Northwest. The hemorrhage observed is associated with In dogs with diarrhea, fecal fl otation and direct smear gastric biopsy. examination should be performed to screen for primary or concurrent parasitism (Figure 1). In patients with clinical fi ndings (Table 2) or laboratory results that suggest a serious underlying cause, or those that do not respond to therapy, further diagnostic evaluation is indicated. Early identifi cation is especially important in patients requiring surgical intervention, such as those with an obstructive intestinal foreign body (Figure 2). Imaging Abdominal ultrasonography and/or abdominal Learn More radiography are strongly advised in patients Turn to page 77 to presenting with abdominal pain to screen for diseases read the article, requiring surgical intervention. It is important to Endoscopic Foreign Body Retrieval. FIGURE 2. Fabric gastric foreign body visualized TABLE 2. during gastroscopy. Selected Clinical Findings That Indicate Further Diagnostic Evaluation in Dogs & remember that pancreas-specifi c lipase concentrations Cats with Acute Vomiting and/or Diarrhea can be increased in dogs and cats with gastrointestinal • Abdominal pain foreign bodies. Therefore, it is essential to rule out • Anorexia • Bradycardia gastrointestinal foreign bodies with abdominal • Chronic vomiting or diarrhea radiographs and, possibly, abdominal ultrasound Hematemesis • before pancreatitis is diagnosed. If there is high • Hyperthermia or fever • Jaundice suspicion for a gastrointestinal foreign body that • Lack of current vaccinations may have been obscured by fl uid or gas, diagnostic • Lymphadenopathy imaging should be repeated. • Masses or organomegaly on abdominal palpation • Melena • Polyuria/polydipsia THERAPEUTIC APPROACH • Tachycardia When acute gastroenteritis is the primary cause • Tachypnea, cough, or abnormal lung sounds • Weak pulses of vomiting and/or diarrhea, the symptomatic • Weakness treatments discussed in this article are appropriate • Weight loss for therapy. However, if gastroenteritis occurs tvpjournal.com | November/December 2015 | TODAy’S VETERINARy PRACTICE 47 Peer Reviewed SYMPTOMATIC MANAGEMENT OF PRIMARY ACUTE GASTROENTERITIS secondary to an underlying disease, such as Ondansetron & Dolasetron hypoadrenocorticism, it is essential to treat the Ondansetron and dolasetron are serotonin (5-HT3) primary condition in addition to providing antagonists with potent antiemetic activity that are symptomatic and supportive therapy. commonly used off-label to control nausea in dogs This article emphasizes symptomatic treatment of and cats. This class of drug blocks the chemoreceptor primary acute gastroenteritis rather than detailing trigger zone and vagal afferent pathways involved specific treatment of serious underlying diseases that in emesis. In our experience, these drugs are very may cause similar clinical signs. effective for control of vomiting in dogs and cats. ANTIEMETIC DRUGS Maropitant For acute gastroenteritis, antiemetic therapy is often Substance P is a neurotransmitter that binds to used for the initial 24 to 48 hours when vomiting is a neurokinin-1 (NK-1) receptors and can result in prominent clinical sign (Table 3). Benefits include: vomiting. Therefore, NK-1 receptor antagonists • Improved patient comfort are powerful antiemetics effective at treating both • Decreased ongoing fluid and electrolyte losses peripheral and central causes of vomiting. • Earlier reintroduction of enteral nutrition Maropitant, a NK-1 receptor antagonist, is • Reduced risk of esophagitis and esophageal currently the only licensed antiemetic for use in dogs stricture formation. and cats and, in our opinion, is very effective. This Take care not to mask ongoing disease with drug may also have an analgesic effect and, thus, is prolonged (ie, greater than 3 days) antiemetic widely used in patients with vomiting and abdominal therapy. In addition, to reduce the risk of pain, such as those with pancreatitis.1 The efficacy gastrointestinal perforation and avoid delay of of maropitant for the control of presumed nausea is surgical intervention by masking clinical signs of controversial as some studies have shown a benefit intestinal obstruction, do not administer antiemetic while others have not documented a benefit.2-6 or prokinetic drug therapy when a foreign body is While maropitant is not licensed for IV use, we suspected or confirmed. and other clinicians have administered it by this Several classes of antiemetic drugs are used in small route—at a dose of 1 mg/kg Q 24 H—without animal medicine. Occasionally, refractory cases require the apparent adverse effects. The manufacturer use of more than one of these drugs at the same time. recommends that after 5 days of continuous TABLE 3. Medical Therapy for Vomiting Due to Acute Gastroenteritis DRUG DOGS CATS Antiemetics Ondansetron 0.1–1 mg/kg PO Q 12–24 H 0.1–1 mg/kg PO or IV Q 12–24 H Dolasetron 0.5–1 mg/kg IV Q 12 H 0.6 mg/kg IV Q 12 H Maropitant 1 mg/kg SC Q 24 H 1 mg/kg SC Q 24 H 2 mg/kg PO Q 24 H 2 mg/kg PO Q 24 H 1 mg/kg IV Q 24 Ha 1 mg/kg IV Q 24 Ha Metoclopramide 0.2 mg/kg SC or PO Q 8 H 0.2–0.4 mg/kg PO or SC Q 6–8 H 1–2 mg/kg/H IV CRI 1–2 mg/kg/H IV CRI Gastroprotectants Sucralfate 0.5–1 g PO Q 8–12 H (tablet or slurry)b 0.5 g PO Q 8–12 H (tablet or slurry)b Famotidine 1 mg/kg PO or IV Q 12 H 1 mg/kg PO or IV Q 12 H Omeprazole 1 mg/kg PO Q 12 H 1 mg/kg PO Q 12 H Pantoprazole 1 mg/kg IV Q 24 H 1 mg/kg IV
Load more

Recommended publications
  • Campylobacter:What You Need to Know
    Queensland Health Campylobacter: what you need to know Campylobacter is one of the most Age groups most at risk common causes of foodborne illness Under in Australia. 60+ You can’t see it, smell it or even taste it on food, but if 5s it affects you, you won’t forget it. What is Campylobacter? Campylobacter is a little known foodborne bacteria similar to Salmonella. * In some cases Campylobacter can also lead to irritable 230,000 bowel syndrome, reactive arthritis and in rare cases cases a year Guillain-Barré syndrome—a type of paralysis. How do you get it? Most cases of Campylobacter infection are associated ** with eating raw or undercooked poultry or by cross 3200 contamination. hospitalisations as It is important to keep raw poultry and their juices a result of foodborne away from any already cooked or ready-to-eat foods illness caused by and fresh produce. Campylobacter Who is at risk? Anyone can be affected by Campylobacter but certain $1.25 billion people are at a greater risk for severe illness including annual total cost to society young children (under 5 years), older adults (over 60 for foodborne illness in years) and people with weakened immunity. Australia How to prevent it The easiest way to protect yourself and your family is to follow our four food safety tips every time you prepare raw poultry. ! Symptoms of Campylobacter Campylobacter infections cause gastroenteritis Follow these four safety tips (commonly known as gastro) diarrhoea, abdominal pains, cramping and fever. to prevent foodborne illness Symptoms usually start two to five days after from Campylobacter infection, and can last for one to three weeks.
    [Show full text]
  • Astroviruses As Causative Agents of Gastroenteritis
    Under the Microscope Astroviruses as causative agents of gastroenteritis with other enteric pathogens, especially rotaviruses, are known. Most infections in adults are asymptomatic. In other mammalian species, infection results in diarrhoea and gastroenteritis, while infection in birds leads to extraintestinal diseases, including Enzo A Palombo interstitial nephritis in young chicks and acute hepatitis in Environment and Biotechnology ducklings2. Centre Faculty of Life and Social Sciences Swinburne University of Epidemiology Technology Hawthorn VIC 3122 The first description of astrovirus came in 1975 after electron microscopic analysis of diarrhoeal stool samples from infants3,4. Astroviruses were first identified over 30 years ago and The unusual appearance of the virion particles (10% show a the virus was soon established as an important cause of characteristic five- or six-pointed star pattern on their surface) gastroenteritis, particularly in young children. Human indicated a previously unrecognised virus. Astroviruses have astrovirus disease was thought to result from infection since been reported worldwide in samples from infants and by a limited number of serotypes. However, recent young children with gastroenteritis. Soon after the first report in studies have indicated that the extent of genetic diversity humans, astrovirus-like particles were observed in domesticated is greater than previously assumed. In addition, the animals. There is now abundant evidence that astroviruses are widespread occurrence among animals and reports of widespread among domestic, synanthropic and wild animals, avian recombination and possible cross-species transmission and mammalian species in terrestrial and aquatic environments1. suggest that astroviruses have zoonotic potential. The list of animal species from which astroviruses have been Astroviruses are small (28–30 nm), non-enveloped viruses identified (chronologically) includes sheep, cattle, chickens, belonging to the family Astroviridae.
    [Show full text]
  • Report of Two Cases Presenting with Acute Abdominal Symptoms
    Journal of Accident and Tension pneumothorax: report of two cases presenting J Accid Emerg Med: first published as 10.1136/emj.11.1.43 on 1 March 1994. Downloaded from Emergency Medicine 1993 with acute abdominal symptoms 10, 43-44 G.W. HOLLINS,1 T. BEATTIE,1 1. HARPER2 & K. LITTLE2 Departments of Accident and Emergency 1 Aberdeen Royal Infirmary, Foresterhill, Aberdeen and 2Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh INTRODUCTION diagnoses were peptic ulcer disease or acute pancreatitis. Work-up appropriate to these diag- Tension pneumothorax constitutes a medical noses was commenced. An erect chest radiograph emergency and rapid diagnosis should be possible revealed a large pneumothorax with mediastinal on the basis of history and clinical examination. shift to the left. Following drainage using a large Following treatment with the delivery of high con- bore needle there was immediate resolution of his centration oxygen and the insertion of a large bore symptoms and all abdominal signs. An intercostal needle into the pleural space of the affected side, chest drain was formally sited and full expansion of the diagnosis can be confirmed radiologically and his right lung was achieved after 36 h. He was dis- an intercostal chest drain formally sited.1'2 We report charged home after 3 days. two cases where diagnosis was not made on the basis of history and examination alone. Both cases Case 2 presented with symptoms and signs suggestive of an acute intra-abdominal pathology and the diag- A 37-year-old male computer operator presented nosis was only made on radiological grounds. with a 1-week history of general malaise associated with mild neck and back pain.
    [Show full text]
  • Diagnosis and Treatment of Perianal Crohn Disease: NASPGHAN Clinical Report and Consensus Statement
    CLINICAL REPORT Diagnosis and Treatment of Perianal Crohn Disease: NASPGHAN Clinical Report and Consensus Statement ÃEdwin F. de Zoeten, zBrad A. Pasternak, §Peter Mattei, ÃRobert E. Kramer, and yHoward A. Kader ABSTRACT disease. The first description connecting regional enteritis with Inflammatory bowel disease is a chronic inflammatory disorder of the perianal disease was by Bissell et al in 1934 (2), and since that time gastrointestinal tract that includes both Crohn disease (CD) and ulcerative perianal disease has become a recognized entity and an important colitis. Abdominal pain, rectal bleeding, diarrhea, and weight loss consideration in the diagnosis and treatment of CD. Perianal characterize both CD and ulcerative colitis. The incidence of IBD in the Crohn disease (PCD) is defined as inflammation at or near the United States is 70 to 150 cases per 100,000 individuals and, as with other anus, including tags, fissures, fistulae, abscesses, or stenosis. autoimmune diseases, is on the rise. CD can affect any part of the The symptoms of PCD include pain, itching, bleeding, purulent gastrointestinal tract from the mouth to the anus and frequently will include discharge, and incontinence of stool. perianal disease. The first description connecting regional enteritis with perianal disease was by Bissell et al in 1934, and since that time perianal INCIDENCE AND NATURAL HISTORY disease has become a recognized entity and an important consideration in the Limited pediatric data describe the incidence and prevalence diagnosis and treatment of CD. Perianal Crohn disease (PCD) is defined as of PCD. The incidence of PCD in the pediatric age group has been inflammation at or near the anus, including tags, fissures, fistulae, abscesses, estimated to be between 13.6% and 62% (3).
    [Show full text]
  • Acute Pancreatitis Associated with Rotavirus Infection and Review Of
    Case Report/Olgu Sunumu İstanbul Med J 2020; 21(1): 78-81 DO I: 10.4274/imj.galenos.2020.88319 Acute Pancreatitis Associated with Rotavirus Infection and Review of The Literature Rotavirüs Enfeksiyonuna Bağlı Akut Pankreatit Olguları ve Literatürün Gözden Geçirilmesi Kamil Şahin, Güzide Doğan University of Health Sciences, Haseki Training and Research Hospital, Department of Pediatrics, İstanbul, Turkey ABSTRACT ÖZ Agents causing acute gastroenteritis are not common causes of Çocuklarda pankreatit etiyolojisinde akut gastroenterit etkenleri pancreatitis etiology in children. Pancreatitis associated with sık görülen sebeplerden değildir. Rotavirüs enfeksiyonuna rotavirus infection is very rare. Cases with acute pancreatitis bağlı görülen pankreatit ise oldukça nadirdir. Rotavirüs during rotavirus gastroenteritis are reported due to rare gastroenteriti sırasında akut pankreatit gelişen olgular, associations. In this article, the causes of acute pancreatitis rotavirüs enfeksiyonuna bağlı akut pankreatitin nadir olması and cases of acute pancreatitis due to rotavirus infection were nedeniyle sunulmuştur. Bu yazıda, akut pankreatit sebepleri ve investigated. Clinical findings were mild, and complications rotavirüse bağlı gelişen akut pankreatit olguları incelenmiştir. were not observed in both of our patients, including a two- İki yaş kız ve üç yaşındaki erkek iki olgumuzda ve literatürde year-old female and a three-year-old male, and other cases değerlendirilen diğer olgularda klinik bulgular hafif seyretmiş, evaluated in the literature. The
    [Show full text]
  • Hepatitis C – Screening, Diagnosis, Management & Treatment
    12 Osteopathic Family Physician (2019) 12 - 19 Osteopathic Family Physician | Volume 11, No. 1 | January/February, 2019 Review ARTICLE Hepatitis C – Screening, Diagnosis, Management & Treatment Michael Ferraro, DO & Matthew StantsPainter, DO Washington Health System Family Medicine Residency Program, Washington, PA KEYWORDS: Abstract: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, hepatocellular carcinoma and cirrhosis with at least 185 million people infected worldwide, causing 399,000 deaths Disease Prevention annually. HCV is transmitted through blood or body fluids. Transmission most commonly occurs and Wellness through sharing of injection drug, occupational exposure through needlestick injuries in healthcare Hepatitis C settings, and birth to an HCV infected mother. There are seven known genotypes of HCV, 1a, 1b, 2, 3, 4, 5, and 6, with the most common genotypes in the U.S. being 1a, 1b, 2, and 3, which comprise Infectious Disease approximately 97% of all U.S. HCV infections. Risks for disease progression include baseline liver histology, age, ethnicity, gender, alcohol use, comorbidities and immune response. There are Jaundice multiple screening recommendations currently in place, some of which are based on risk factors, Transaminitis with others based on legislation. The screening test of choice is the anti-Hepatitis C virus antibody, with a confirmatory HCV RNA PCR with genotyping. Once the diagnosis is made, assessing the level of fibrosis and/or cirrhosis is an important step in determining the pathway to treatment. There are multiple new options for treatment with improved efficacy and less side effects. Patient being treated for HCV should be monitored and assessed for compliance with therapy and adverse effects, including new or worsening psychiatric illness and screened for alcohol and substance abuse.
    [Show full text]
  • Acute Gastroenteritis
    Article gastrointestinal disorders Acute Gastroenteritis Deise Granado-Villar, MD, Educational Gap MPH,* Beatriz Cunill-De Sautu, MD,† Andrea In managing acute diarrhea in children, clinicians need to be aware that management Granados, MDx based on “bowel rest” is outdated, and instead reinstitution of an appropriate diet has been associated with decreased stool volume and duration of diarrhea. In general, drug therapy is not indicated in managing diarrhea in children, although zinc supplementation Author Disclosure and probiotic use show promise. Drs Granado-Villar, Cunill-De Sautu, and Objectives After reading this article, readers should be able to: Granados have disclosed no financial 1. Recognize the electrolyte changes associated with isotonic dehydration. relationships relevant 2. Effectively manage a child who has isotonic dehydration. to this article. This 3. Understand the importance of early feedings on the nutritional status of a child who commentary does has gastroenteritis. contain a discussion of 4. Fully understand that antidiarrheal agents are not indicated nor recommended in the an unapproved/ treatment of acute gastroenteritis in children. investigative use of 5. Recognize the role of vomiting in the clinical presentation of acute gastroenteritis. a commercial product/ device. Introduction Acute gastroenteritis is an extremely common illness among infants and children world- wide. According to the Centers for Disease Control and Prevention (CDC), acute diarrhea among children in the United States accounts for more than 1.5 million outpatient visits, 200,000 hospitalizations, and approximately 300 deaths per year. In developing countries, diarrhea is a common cause of mortality among children younger than age 5 years, with an estimated 2 million deaths each year.
    [Show full text]
  • Descriptive Study Regarding the Etiological Factors Responsible for Secondary Bacterial Peritonitis in Patients Admitted in a Te
    International Journal of Health Sciences and Research Vol.10; Issue: 7; July 2020 Website: www.ijhsr.org Original Research Article ISSN: 2249-9571 Descriptive Study Regarding the Etiological Factors Responsible for Secondary Bacterial Peritonitis in Patients Admitted in a Tertiary Care Hospital in Trans Himalayan Region Raj Kumar1, Rahul Gupta2, Anjali Sharma3, Rajesh Chaudhary4 1MS General Surgery, Civil Hospital Baijnath, Himachal Pradesh 2MD Community Medicine, District Programme Officer, Health and Family Welfare, Himachal Pradesh 3Resident Doctor, Department of Microbiology, DRPGMC Kangra at Tanda, Himachal Pradesh 4MS General Surgery, Civil Hospital Nagrota Bagwan, Himachal Pradesh Corresponding Author: Rahul Gupta ABSTRACT Peritonitis is an inflammation of the peritoneum. Primary peritonitis which is spontaneous bacterial peritonitis, Secondary peritonitis due to infection from intraabdominal source or spillage of its contents and Tertiary peritonitis which is recurrent or reactivation of secondary peritonitis. The present study was aimed to determine the etiology of generalized secondary peritonitis among the patients admitted in Department of General Surgery, Dr RPGMC Kangra at Tanda. This descriptive observational study was conducted in the department of surgery Dr. Rajendra Prasad Government Medical College Kangra at Tanda consisting of patients having acute generalised secondary peritonitis presented in emergency department or Surgery outdoor patient department over a period of one year from December 2016 through November 2017. The most common etiology of generalized secondary peritonitis in our patients was peptic ulcer disease (77.13%) followed by perforated appendicitis (9.8%). Etiological factors of secondary generalised peritonitis have a different pattern in different geographical regions. Peptic ulcer disease remains the commonest etiology of secondary peritonitis in India followed by enteric perforation which is in contrast to the western studies where appendicular and colon perforations are more common.
    [Show full text]
  • PERFORATED PEPTIC ULCER. Patient Usually Experiences
    Postgrad Med J: first published as 10.1136/pgmj.12.134.470 on 1 December 1936. Downloaded from 470 POST-GRADUATE MEDICAL JOURNAL December, 1936 PERFORATED PEPTIC ULCER. By RONALD W. RAVEN, F.R.C.S. (Assistant Surgeon to T'he French Hospital, Assistant Surgeon to The Gordon Hospital for Rectal Diseases and Swrgical Registrar to The Royal Cancer Hospital.) INTRODUCTION. Peptic ulceration is a crippling disease judged from the stand-point of morbidity, and is also dangerous to life on account of serious complications, such as haemorrhage or perforation which may supervene during the course of the disease. These complications may occur in any patient and there are no criteria which will indicate whether or not an ulcer will bleed or perforate. When the treatment of peptic ulceration is under review it must be remembered that from 20 to 30 per cent. of these ulcers perforate. In a large series of cases I found that the incidence of perforation was 27 per cent. It is thus essential that patients suffering with peptic ulcer should be kept under continuous careful observation. Unfortunately, however, a small percentage of patients give no previous history of the peptic ulcer syndrome and perforation of the ulcer is the first indication of its presence. Recently, when considering the role of surgery in the treatment of chronic peptic ulcer, Joll stated that there has been a rise in the incidence of perforation as a complication of peptic ulcer since medical treatment has become systematized in the treatment of this disease. It must also be remembered that medical treat- Protected by copyright.
    [Show full text]
  • Medical Terminology Abbreviations Medical Terminology Abbreviations
    34 MEDICAL TERMINOLOGY ABBREVIATIONS MEDICAL TERMINOLOGY ABBREVIATIONS The following list contains some of the most common abbreviations found in medical records. Please note that in medical terminology, the capitalization of letters bears significance as to the meaning of certain terms, and is often used to distinguish terms with similar acronyms. @—at A & P—anatomy and physiology ab—abortion abd—abdominal ABG—arterial blood gas a.c.—before meals ac & cl—acetest and clinitest ACLS—advanced cardiac life support AD—right ear ADL—activities of daily living ad lib—as desired adm—admission afeb—afebrile, no fever AFB—acid-fast bacillus AKA—above the knee alb—albumin alt dieb—alternate days (every other day) am—morning AMA—against medical advice amal—amalgam amb—ambulate, walk AMI—acute myocardial infarction amt—amount ANS—automatic nervous system ant—anterior AOx3—alert and oriented to person, time, and place Ap—apical AP—apical pulse approx—approximately aq—aqueous ARDS—acute respiratory distress syndrome AS—left ear ASA—aspirin asap (ASAP)—as soon as possible as tol—as tolerated ATD—admission, transfer, discharge AU—both ears Ax—axillary BE—barium enema bid—twice a day bil, bilateral—both sides BK—below knee BKA—below the knee amputation bl—blood bl wk—blood work BLS—basic life support BM—bowel movement BOW—bag of waters B/P—blood pressure bpm—beats per minute BR—bed rest MEDICAL TERMINOLOGY ABBREVIATIONS 35 BRP—bathroom privileges BS—breath sounds BSI—body substance isolation BSO—bilateral salpingo-oophorectomy BUN—blood, urea, nitrogen
    [Show full text]
  • Case Report: a Patient with Severe Peritonitis
    Malawi Medical Journal; 25(3): 86-87 September 2013 Severe Peritonitis 86 Case Report: A patient with severe peritonitis J C Samuel1*, E K Ludzu2, B A Cairns1, What is the likely diagnosis? 2 1 What may explain the small white nodules on the C Varela , and A G Charles transverse mesocolon? 1 Department of Surgery, University of North Carolina, Chapel Hill NC USA 2 Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi Corresponding author: [email protected] 4011 Burnett Womack Figure1. Intraoperative photograph showing the transverse mesolon Bldg CB 7228, Chapel Hill NC 27599 (1a) and the pancreas (1b). Presentation of the case A 42 year-old male presented to Kamuzu Central Hospital for evaluation of worsening abdominal pain, nausea and vomiting starting 3 days prior to presentation. On admission, his history was remarkable for four similar prior episodes over the previous five years that lasted between 3 and 5 days. He denied any constipation, obstipation or associated hematemesis, fevers, chills or urinary symptoms. During the first episode five years ago, he was evaluated at an outlying health centre and diagnosed with peptic ulcer disease and was managed with omeprazole intermittently . His past medical and surgical history was non contributory and he had no allergies and he denied alcohol intake or tobacco use. His HIV serostatus was negative approximately one year prior to presentation. On examination he was afebrile, with a heart rate of 120 (Fig 1B) beats/min, blood pressure 135/78 mmHg and respiratory rate of 22/min. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness in the epigastrium.
    [Show full text]
  • Innovative Care for Chronic Conditions
    Innovative Care for Chronic Conditions Building Blocks for Action global report Noncommunicable Diseases and Mental Health World Health Organization WHO Library Cataloging-in-Publication Data Innovative care for chronic conditions: building blocks for action: global report 1. Chronic disease 2. Delivery of health care, Integrated 3. Long-term care 4. Public policy 5. Consumer participation 6. Intersectoral cooperation 7. Evidence-based medicine I. World Health Organization. Health Care for Chronic Conditions Team. ISBN 92 4 159 017 3 (NLM classification: WT 31) This publication is a reprint of material originally distributed as WHO/MNC/CCH/02.01 © World Health Organization 2002 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to repro- duce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]