Possible Causes for epigastric tenderness Acute Cholecystitis There is moderate epigastric tenderness and guarding throughout the abdomen, but no rigidity. Pelvic and rectal examination results are unremarkable. [jamaevidence.mhmedical.com] tenderness to palpation Variable presence of rebound/guarding Tenderness with an inspiratory pause during palpation of the RUQ during a deep breath (Murphy’s sign) Best test [coreem.net] Rebound tenderness and guarding are often present. [nursingcenter.com] Malignant Neoplasm of the Stomach Case Report A 48-year-old man visited our hospital in December 1994 with a chief complaint of epigastric discomfort. [academic.oup.com] On physical examination, the abdomen was soft and flat with neither palpable mass nor tenderness. No peripheral lymphadenopathy was observed. [academic.oup.com] Splenic Rupture He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. [ncbi.nlm.nih.gov] On examination she was pale and had abdominal tenderness predominant in the right upper quadrant. [ncbi.nlm.nih.gov] Abdominal tenderness was experienced in the left upper quadrant and epigastric region with rebound tenderness. [abdominalsurg.org] Peptic Ulcer There may be some epigastric tenderness, but often there are no other signs on physical examination. [bestpractice.bmj.com] tenderness the most frequent finding in patients with Gastric Ulcer or Duodenal Ulcer Pain may be found to the right of the midline in 20% of patients. [clinicclinic2.cafe24.com] tenderness. [patient.info] Malignant Neoplasm of the Pancreas Pancreatic cancer is a type of cancer that starts in the pancreas. (Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer? ) Pancreatic adenocarcinoma is the most common type of pancreatic cancer. Pancreatic neuroendocrine[…] [cancer.org] Cystic Fibrosis As antimicrobial-resistant microbes become increasingly common and a significant global issue, novel approaches to treating these infections particularly in those at high risk are required. This is evident in people with cystic fibrosis (CF), who suffer from chronic airway infection caused by antibiotic resistant[…] [ncbi.nlm.nih.gov] Duodenal Disease BACKGROUND: There is a high prevalence of gastro-duodenal disease in sub-Saharan Africa. Peptic ulcer disease in dyspeptic patients, 24.5%, was comparable to prevalence of gastro-duodenal disease among symptomatic individuals in developed countries (12 - 25%). Limited data exists regarding its associated risk[…] [ncbi.nlm.nih.gov] Gastrointestinal Stromal Tumor In contrast to adult mutant gastrointestinal stromal tumors [GISTs], pediatric/wild-type GISTs remain poorly understood overall, given their lack of oncogenic activating tyrosine kinase mutations. These GISTs, with a predilection for gastric origin in female patients, show limited response to therapy with tyrosine[…] [ncbi.nlm.nih.gov] Duodenal Diverticulum Physical examination revealed nothing abnormal except some epigastric tenderness. Laboratory examinations were normal. [birpublications.org] Epigastric tenderness was evident on physical examination. [wjgnet.com] On clinical examination, she had epigastric tenderness and no signs of peritoneal irritation. [bmcgastroenterol.biomedcentral.com] Cholelithiasis Mild right upper quadrant or epigastric tenderness may be present; peritoneal findings are absent. Between episodes, patients feel well. [msdmanuals.com] Gastric Syphilis We report a 43-yr-old man suffering from epigastric tenderness with an initial diagnosis of gastric carcinoma; gastric syphilis was confirmed by demonstrating spirochetes [ncbi.nlm.nih.gov] Epigastric pain/fullness was the most common presenting symptom (92%) and epigastric tenderness being the most common sign. [ncbi.nlm.nih.gov] Physical examinations were normal except minimal epigastric tenderness only. [synapse.koreamed.org] Emphysematous Gastritis […] bpm) and mild epigastric tenderness. Blood tests showed neutrophil predominant leukocytosis and bilirubin raised up to 45？ mol/L. [oalib.com] On examination he had a distended abdomen and epigastric area tenderness without peritoneal signs. He was hemodynamically stable. [meetings.ssat.com] Physical examination of the abdomen reveals epigastric tenderness, distension, and decreased bowel sounds (4, 12). Radiologically it has a characteristic appearance. [ncbi.nlm.nih.gov] Acute Alcohol Intoxication Intermittent sever epigastric and RUQ pain; usually asssociated with nausea and vomiting. Tenderness over gall bladder during acute episodes. [armandoh.org] The physical examination may reveal fever, tachycardia, and tenderness in the RUQ or epigastric region, often with guarding or rebound. [emedicine.medscape.com] Generally, the patient presents with abdominal distension or epigastric discomfort, especially after a fatty meal. [slideshare.net] Epigastric Hernia On abdominal examination, right upper quadrant pain, distension, and epigastric tenderness is common1,3,5. [scielo.br] —An 84-year-old man with a 15-year history of a reducible epigastric hernia was admitted with abdominal pain, vomiting, and a tender, irreducible 15-cm epigastric mass with [jamanetwork.com] Dr Virendra Parikh of Fort Wayne, Ind, found a slightly tender, vague epigastric mass that extended to the right upper quadrant. Signs of peritonitis were absent. [patientcareonline.com] Cannabinoid Hyperemesis Syndrome His examination was unremarkable except for dry mucosa and epigastric tenderness. His labs were also insignificant except for prerenal azotemia. [the-hospitalist.org] Physical examination was unremarkable except for epigastric tenderness to palpation. [cureus.com] Ovarian Cyst A large abdominal mass was visible and palpable in the periumbilical and epigastric regions. [ncbi.nlm.nih.gov] […] robsonmarcia@netsite.com.br Abstract A 10-year-old premenarchal girl was admitted to our hospital with moderate abdominal pain, although presenting no vomiting or abdominal rebound tenderness [ncbi.nlm.nih.gov] Allergic Rhinitis The clinical exam revealed severe malaise, pallor, decreased skin turgor, abdominal epigastric tenderness, heartburn at palpation within the epigastric area. [ncbi.nlm.nih.gov] […] admitted in our clinic for acute onset fever refractory to antipyretics, chest pain, anorexia, refusal of solid food, accepting only small amounts of fluids, odynophagia, and epigastric [ncbi.nlm.nih.gov] Acute Pancreatitis On physical examination, abdominal bulging and mild epigastric tenderness were detected. Laboratory evaluation showed normal amylase and lipase. [ncbi.nlm.nih.gov] Physical exam shows low grade fever, epigastric tenderness, and decreased bowel sounds. [medbullets.com] Acute pancreatitis usually presents with epigastric pain radiating to the back, nausea and vomiting, and epigastric tenderness on palpation. [amboss.com] Cholecystitis There is moderate epigastric tenderness and guarding throughout the abdomen, but no rigidity. Pelvic and rectal examination results are unremarkable. [jamaevidence.mhmedical.com] tenderness to palpation Variable presence of rebound/guarding Tenderness with an inspiratory pause during palpation of the RUQ during a deep breath (Murphy’s sign) Best test [coreem.net] Typically epigastric tenderness. Risk factors like non-steroidal anti-inflammatory drugs (NSAIDs), alcohol use. Acute hepatitis: Typical transaminitis. Jaundice. [clinicaladvisor.com] Duodenal Hematoma Physical examination revealed scleral icterus, abdominal distention, and epigastric tenderness. [karger.com] Abdominal exam demonstrated hypoactive bowel sounds, epigastric tenderness, without rebound tenderness or guarding. [wjgnet.com] The abdomen was minimally distended and soft with minimal epigastric tenderness and no palpable mass. An erect chest X-ray showed no pneumoperitoneum. [pancreas.imedpub.com] Biliary Colic tenderness -may be jaundiced (i.e. if blocking flow of bile in the common bile duct)- but more often not Investigations: -Bloods FBC- WCC normal, distinguishing biliary colic [clumsylostmedicalstudent.wordpress.com] Patients with biliary colic will generally only have right upper quadrant (RUQ) or epigastric tenderness on physical exam. [ncbi.nlm.nih.gov] Mild right upper quadrant or epigastric tenderness may be present; peritoneal findings are absent. Between episodes, patients feel well. [merckmanuals.com] Penetrating Duodenal or Gastric Ulcer tenderness) What is important is to be able to assess patients for dyspepsia with alarm features e.g. [dundeemedstudentnotes.wordpress.com] Signs The only signs are those of epigastric tenderness but this is a poor discriminating sign. [medassignments.com] Signs;Physical examination is of limited valuein patients with uncomplicated ulcer.For epigastric tenderness on deeppalpation, the sensitivity and specificityare all approximately [slideshare.net] Ischemic Ulcer His physical examination was unremarkable except for epigastric tenderness and bilateral temporal and extremities wasting. [hindawi.com] Upper Airway Cough Syndrome Examination is unremarkable other than mild epigastric tenderness on palpation and a BMI of 38 kg/m 2. [guidelinesinpractice.co.uk] Examination is unremarkable other than mild epigastric tenderness on palpation and a BMI of 38 kg/m2. [guidelinesinpractice.co.uk] Pyloric Obstruction Examination revealed normal vital signs and epigastric tenderness. Initial impressions were of gastritis, biliary colic, or peptic ulcer disease (PUD). [academic.oup.com] Patients with GOO can present with nausea, post-prandial vomiting, early satiety, dehydration, abdominal bloating, weight loss, and epigastric tenderness. [cancertherapyadvisor.com] Gastritis Depends on the etiology (see below). asymptomatic epigastric pain/tenderness nausea and vomiting loss of appetite Etiology infection: H. pylori (most common) systemic illness [radiopaedia.org] […] pain/fullness, tenderness, and upper gastrointestinal bleeding as symptoms. [en.wikipedia.org] […] problems of the gastric tissues.[24] Gastric syphilis[edit] A previous history with the syphilis disease has not been encountered in about 13% of patients who experience epigastric [en.wikipedia.org] Influenza On physical examination, there was epigastric tenderness, but no other signs, such as skin rash. On the second day, she vomited blood 10 times. [ncbi.nlm.nih.gov] A 4-year-old girl with influenza presented with epigastric pain and vomiting. [ncbi.nlm.nih.gov] Choledocholithiasis Abdominal exam demonstrates right upper quadrant and epigastric tenderness without guarding or rebound. [medbullets.com] He reported epigastric tenderness on palpation. The liver and spleen were not palpable. Murphy's sign was negative. [ncbi.nlm.nih.gov] Liver Hematoma In physical examination epigastric tenderness was present. [scopemed.org] The abdomen was distended, tender with guarding and rebound tenderness in the upper part of the abdomen. The bowl sounds were not heard. [saudijgastro.com] On the second post partum day the patient complained of severe epigastric and right hypochondrial pain accompanied by nausea and vomiting. [saudijgastro.com] Umbilical Hernia Epigastric hernia presents as a tender lump in the midline of the epigastrium. Investigation No investigations are required in uncomplicated cases. [bettersafercare.vic.gov.au]
