GI bleeding(消化道出血)_重庆医大《检体诊断学》课件.pptVIP

(b) tenesmus Rectum and anus diseases (c) Fever Infectious diseases : septemia viral hemorrhagic fever Carcinoma: lymphomas leukemias (d) Hemorrhage of skin and mucosa Hematologic diseases Infectious diseases (e) Skin change Spider nevi Palmar erythema Superficial varicose veins of abdomen Cirrhosis (f) Abdominal mass Lymphomas Colorectal cancer Intestinal tuberculosis Crohn’s disease History question Hematochezia /paradoxical hematochezia Aggravating factors：drinking, taking drugs, or cold and irritants Color: contribute to judge the site and rapidity of bleeding Volume of blood loss General condition：T, P, R, Bp Past history ：chronic abdomen pain , dyspepsia, diarrhea, bloating, major surgery procedures, and taking drugs for a long period References： Textbook of physical diagnosis. 4th edition. MH Swartz. Elsevier science. 2002 Gastrointestinal hemorrhage . TEXTBOOK of MEDICINE, 18th edition, edited by James B. Wyngaarden and Lloyd H. Smith. 1988, W.B. Saunders company. 796-799. Acute and Chronic Gastrointestinal Bleeding. Sleisenger Fordtran’s Gastrointestinal and Liver Disease, 6th edition, volume 2, edited by Mark Feldman, Bruce F. Scharschmidt and Marvin H. Sleisenger. 2001, W.B. Saunders company. 198-219 * peptic ulcer disease bleeding esophageal / gastric varices acute mucosal lesions * . The bleeding may be massive with the rapid development of shock, or the bleeding may stop spontaneously only to recur later. * The most common presenting features of hepatocellular carcinoma are abdominal pain, the presence of an abdominal mass, and weight loss. Alpha-fetoprotein levels in serum greater than 500 ng per milliliter or progressively rising levels are highly suggestive of hepatocellular carcinoma. * One person has jaundice, chill, fever, and the onset of a typical biliary pain. Anorexia, nausea and vomiting may accompany the attack. Then the causes of this patient may ori