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Vomiting and gastric stasis/gastroparesis Vomiting and gastric stasis/gastroparesis
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Clinical features Clinical features
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Causes Causes
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Evaluation Evaluation
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Investigations Investigations
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Gastroparesis Gastroparesis
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Evaluation Evaluation
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Management Management
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Gastric erosions Gastric erosions
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Definition Definition
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Epidemiology Epidemiology
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Incidence Incidence
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Risk factors Risk factors
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Factors relevant to critical care gastric erosions Factors relevant to critical care gastric erosions
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Pathology Pathology
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Prevention Prevention
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Treatment: mild bleed Treatment: mild bleed
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Treatment: major bleed Treatment: major bleed
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Nosocomial pneumonia Nosocomial pneumonia
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Studies/evidence Studies/evidence
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Summary Summary
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Diarrhoea Diarrhoea
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Pathophysiology Pathophysiology
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Clinical approach Clinical approach
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History History
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Examination Examination
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Investigations in acute diarrhoea Investigations in acute diarrhoea
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Bloods Bloods
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Microbiology Microbiology
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Faecal biochemical assays Faecal biochemical assays
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Radiology Radiology
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Endoscopy Endoscopy
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Common causes of diarrhoea in the critically ill Common causes of diarrhoea in the critically ill
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Management Management
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Infectious causes Infectious causes
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Non-infectious causes Non-infectious causes
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Upper gastrointestinal haemorrhage (non-variceal) Upper gastrointestinal haemorrhage (non-variceal)
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Definition Definition
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Clinical features Clinical features
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Causes Causes
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Risk factors Risk factors
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Initial assessment Initial assessment
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Management Management
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Resuscitation Resuscitation
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Diagnosis Diagnosis
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Immediate control of bleeding Immediate control of bleeding
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Prevention of re-bleeding/future bleeding Prevention of re-bleeding/future bleeding
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Ulcers Ulcers
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Vascular malformations/Dieulafoy lesions Vascular malformations/Dieulafoy lesions
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Malignancy Malignancy
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Stress-related mucosal damage in critical care patients Stress-related mucosal damage in critical care patients
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Bleeding varices Bleeding varices
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Assessment of the patient with variceal bleeding Assessment of the patient with variceal bleeding
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General measures in management of variceal bleeding General measures in management of variceal bleeding
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Resuscitation Resuscitation
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Correction of coagulopathy Correction of coagulopathy
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Antibiotics Antibiotics
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Balloon tamponade Balloon tamponade
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Medical reduction of portal pressure Medical reduction of portal pressure
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Endoscopic therapy Endoscopic therapy
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Salvage therapy Salvage therapy
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Rectal varices Rectal varices
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Intestinal perforation Intestinal perforation
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Causes Causes
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Clinical approach Clinical approach
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History History
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Drug history Drug history
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Primary presentations Primary presentations
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Secondary presentations Secondary presentations
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Investigations Investigations
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Blood tests Blood tests
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Radiology Radiology
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Treatment options Treatment options
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Conservative Conservative
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Operative Operative
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Intestinal obstruction Intestinal obstruction
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Causes Causes
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Clinical approach Clinical approach
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History History
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Past medical history Past medical history
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Examination Examination
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Investigations Investigations
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Radiology Radiology
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Treatment options Treatment options
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Conservative Conservative
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Operative Operative
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Lower gastrointestinal bleeding Lower gastrointestinal bleeding
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Definition Definition
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Common causes of torrential lower GI haemorrhage Common causes of torrential lower GI haemorrhage
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Less common causes of torrential bleeding Less common causes of torrential bleeding
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Clinical approach Clinical approach
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History History
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Examination Examination
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Investigation Investigation
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Management Management
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Colitis Colitis
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Clinical presentation Clinical presentation
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Differential diagnosis Differential diagnosis
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Investigations Investigations
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Management of acute severe colitis Management of acute severe colitis
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Surgical management Surgical management
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Complications of acute colitis Complications of acute colitis
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Toxic megacolon Toxic megacolon
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Acute GI haemorrhage Acute GI haemorrhage
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Pancreatitis Pancreatitis
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Classification of acute pancreatitis Classification of acute pancreatitis
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Management Management
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Admission to a critical care unit Admission to a critical care unit
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Role of antibiotics Role of antibiotics
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Nutrition Nutrition
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Indications for surgery Indications for surgery
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Management of gallstone-induced pancreatitis Management of gallstone-induced pancreatitis
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Vascular complications Vascular complications
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Abdominal compartment syndrome Abdominal compartment syndrome
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Acute acalculous cholecystitis Acute acalculous cholecystitis
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Definition Definition
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Incidence Incidence
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Risk factors Risk factors
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Organisms Organisms
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Pathogenesis Pathogenesis
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Opportunistic infections Opportunistic infections
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Gallbladder hypoperfusion and ischaemia Gallbladder hypoperfusion and ischaemia
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Bile stasis leading to sepsis Bile stasis leading to sepsis
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Immunosuppression Immunosuppression
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Diagnosis Diagnosis
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High index of suspicion and serial monitoring High index of suspicion and serial monitoring
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Symptoms and signs Symptoms and signs
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Investigations Investigations
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Ultrasound findings Ultrasound findings
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Special investigations Special investigations
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Management Management
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Laparoscopic cholecystectomy Laparoscopic cholecystectomy
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CT- or ultrasound-guided percutaneous transhepatic cholecystostomy CT- or ultrasound-guided percutaneous transhepatic cholecystostomy
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ERCP ERCP
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Conservative management Conservative management
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Complications Complications
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Splanchnic ischaemia Splanchnic ischaemia
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Terminology Terminology
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Pathophysiology Pathophysiology
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Causes Causes
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Diagnosis Diagnosis
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History History
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Physical examination Physical examination
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Laboratory studies Laboratory studies
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Radiology Radiology
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Other investigations Other investigations
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Management Management
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Conservative Conservative
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Endovascular Endovascular
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Operative Operative
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Abdominal hypertension and abdominal compartment syndrome Abdominal hypertension and abdominal compartment syndrome
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Aetiology of IAH/ACS Aetiology of IAH/ACS
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Pathophysiology of organ dysfunction Pathophysiology of organ dysfunction
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Management Management
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Multiple choice questions and further reading Multiple choice questions and further reading
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Cite
Abstract
This chapter discusses gastrointestinal (GI) disorders and includes discussion on vomiting and gastric stasis/gastroparesis, gastric erosions, diarrhoea, upper GI haemorrhage (non-variceal), bleeding varices, intestinal perforation, intestinal obstruction, lower GI bleeding, colitis, pancreatitis, acute acalculous cholecystitis, splanchnic ischaemia, and abdominal hypertension (IAH) and abdominal compartment syndrome. The aim is to provide a summary of the extensive complex abdominal pathologies that can present to an intensive care clinician. Where appropriate, descriptions are provided on clinical presentation, epidemiology, diagnosis (including investigations), and management. Of note, the conditions covered can arise on the ward environment with subsequent requirement for intensive care, but they can also arise de novo on the intensive care unit itself, highlighting the need for intensive care clinicians to maintain a broad knowledge and understanding of their presentation and management.
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