Diffuse upper abdominal tenderness

Introduction Gastric agglomeration, about one-third of the patients in the physical examination can touch the mass in the upper abdomen, and there is diffuse tenderness in the upper abdomen. Gastric agglomeration is when children ingest a large amount of persimmons and black dates on an empty stomach, and the pectin and tannic acid contained in it are coagulated with gastric acid, forming agglomeration in the stomach. Clinically, the pain in the upper abdomen is uncomfortable, and the stomach can be touched by a moving mass. If not treated properly, it can cause gastrointestinal obstruction, ulcers and the like. Symptoms appear half an hour to half a day after eating, mainly due to gastrointestinal dysfunction. Physical examination due to weight loss in children, can be in the middle of the upper abdomen or left to touch the hard block of activity, with mild tenderness. Such as the huge hair block blocking the stomach of the exit, there may be performance of pyloric obstruction.

Cause

Ingestion of certain botanical ingredients or swallowing of hair or certain minerals such as calcium carbonate, tinctures, tinctures, etc., which form foreign substances in the stomach and affect digestive function. Above the disease, the abdomen touches the moving mass with persistent pain and postprandial aggravation as the main clinical manifestations, which can be attributed to the "accumulation" and "stomach pain" of Chinese medicine. The cause is mostly caused by irregular diet. The key to the pathogenesis is the accumulation of fruit and food, and the crusting of the gas; the disease is in the stomach and is closely related to the spleen.

an examination

Related inspection

Abdominal perspective abdominal abdomen abdominal CT

First, peripheral blood examination:

It can be seen that the increase of white blood cells and the increase of neutrophils may have a decrease in hemoglobin and a decrease in red blood cells.

Second, biochemical examination:

Blood sodium, potassium, blood calcium, blood phosphorus, magnesium and blood pH can be changed. In patients with peritonitis, the peritoneal puncture has the result of increased white blood cells.

Third, X-ray inspection:

X-ray barium meal or air sputum double contrast, can be found in the stomach to produce shunt phenomenon, and showed floating in the upper layer of the tincture free, agglomerate, round or oval filling defect area, and gastric mucosal structure finishing The stomach wall is soft. When the sputum in the stomach is empty, there is still a smear, reticular or flaky adhesion on the lumps. There is no obvious tenderness in the shadow of the pressing block, and the contour shape and position can be changed with the force, suggesting that the agglomeration has certain compressibility and migration. Since the persimmon stone cannot pass through the X-ray, the abdominal fluoroscopy or the plain film, the density increase is observed, and the filling meal can be found to have a filling defect, and when the body position is changed, it can move in the stomach.

Differential diagnosis

Upper abdominal mass and bloating: refers to abnormal mass that can be touched during abdominal examination. Bloating is the swelling of the abdomen or discomfort. The two symptoms appear together with problems with the heart, liver, and pancreas.

Sustained severe pain in the right upper quadrant and radiation to the right shoulder: one of the symptoms of acute cholecystitis. Acute cholecystitis is inflammation of the gallbladder caused by cystic duct obstruction and bacterial invasion; its typical clinical features are paroxysmal cramps in the right upper quadrant with obvious tenderness and abdominal stiffness.

There is tenderness in the cystic mass of the left upper abdomen: the cystic inflammatory mass in the left upper abdomen has obvious tenderness, such as the tumor in the middle of the abdomen, which is often a tumor or cyst of the stomach or pancreas, or an intragastric stone.

Upper abdominal pain: refers to the lesions of the internal and external organs caused by various reasons, and the pain of the abdomen.

Upper abdominal pain during starvation: a clinical manifestation of duodenal ulcer. The pain appears in the center of the upper abdomen, just on the umbilicus or just to the right of the midline. Typical duodenal ulcer pain often occurs 2 to 3 hours after a meal (fasting pain) and continues unabated until after eating or taking acid.

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