1, acute and chronic gastritis: unclean diet or irritants + epigastric pain, abdominal distension, nausea and vomiting.
2.Gastroesophageal reflux disease: acid reflux + burning sensation behind the sternum + red strip-like erosion zone in the lower esophagus on gastroscopy (heartburn, acid reflux, food reflux).
3. Peptic ulcers.
Gastric ulcer: chronic regular epigastric pain (pain after a full meal) + or vomiting of blood and black stool.
Duodenal ulcer: pain on hunger or pain at night + or vomiting blood black stool.
Peptic ulcer perforation: sudden onset of severe abdominal pain (signs of peritonitis) + free gas under the diaphragm on X-ray.
4. Esophagogastric fundic varices: upper gastrointestinal hemorrhage + history of previous liver disease.
5, Bacterial dysentery: unclean diet + abdominal pain + mucopurulent stools + posterior urgency.
6, ulcerative colitis: left lower abdominal pain + mucopurulent stools + (stool, relief after stool) + antibiotics are ineffective.
7, acute pancreatitis (edematous type): binge drinking/chronic biliary history + persistent epigastric pain + bending pain relief + amylase test.
Acute pancreatitis (hemorrhagic necrotic type): edema type symptoms + purple spots in the lumbar abdomen or around the umbilicus + laparotomy washings with watery fluid + high blood sugar + low blood calcium.
Hemorrhagic-necrotic type: blood and urine amylase values are not always high, but sometimes fall instead. CT is preferred for confirming the diagnosis, blood amylase is measured within a week, and lipase is measured over a week.
8, pyloric obstruction: vomiting persistent food + vibrating water sound.
9, cirrhosis: history of hepatitis + portal hypertension (splenomegaly + ascites + establishment of collateral circulation) + ultrasound (liver shrinkage).
10, cholecystitis: paroxysmal right upper abdominal colic + positive Murphy’s sign + nausea and vomiting.
11, cholelithiasis: paroxysmal right upper abdominal colic + positive Murphy’s sign + ultrasound strong echogenic light masses and acoustic shadowing.
12, acute obstructive purulent cholangitis: Charcot triad (abdominal pain + chills and high fever + jaundice) + shock manifestations + psychiatric symptoms (such as apathy, coma) five signs.
13.Acute abdominal disease
(1)Appendicitis: metastatic right lower abdominal pain + pressure pain at the point of McDonald’s (distension, boring pain) + elevated WBC.
(2) Intestinal obstruction: abdominal pain + vomiting + distention + closure + X-ray (banana/fluid flat).
Etiology: mechanical and dynamic.
Hematologic: simple and strangulated.
Extent: complete and incomplete.
Department: high and low.
(3) Gastrointestinal perforation: sudden onset of severe epigastric pain + signs of peritoneal irritation + free gas under the diaphragm.
(4) Ectopic pregnancy: vaginal bleeding + history of menopause + severe lower abdominal pain (cervical lifting pain) + elevated chorionic gonadotropin.
(5) Ovarian cystic torsion: change in position + sudden abdominal pain + cystic mass.
(6) Acute pelvic inflammatory disease: (history of curettage) + abnormal leucorrhea + lower abdominal pain + (cervical lifting pain) + purulent discharge.
14.Tumor of digestive system
(1)Gastric cancer: black stool + niche shadow + change in pain pattern of chronic ulcer + epigastric pain + abdominal mass + wasting + enlarged left supraclavicular lymph node.
(2) Esophageal cancer: progressive dysphagia (mid to late stage) + burning pain behind the sternum (early stage) + choking sensation when eating (early stage).
(3) Hepatocellular carcinoma: history of hepatitis + pain in the liver area + elevated AFP + large and hard liver + ascites jaundice + B-ultrasound occupancy.
(4) Rectal cancer: rectal irritation symptoms + blood on fingertip + purulent stool + wasting + stool deformation.
(5) Pancreatic cancer (pancreatic head cancer, peri-pot belly cancer): painless progressive worsening jaundice + clay-colored stool + skin pruritus.
(6) Colon cancer: wasting + change in bowel habit + elevated CEA + abdominal mass.
15.Benign lesions of the anus and rectum
(1) Internal hemorrhoids: painless bloody stools + stools with fresh blood + venous-like masses.
(2) External hemorrhoids: anal pain + fresh blood in stool + painful swelling at the anal opening.
(3) Anal fissure: severe anal pain during and after stool + anal fissure.
16.Abdominal closed injury
Kidney injury: lumbar injury + hematuria.
Liver rupture: (right abdominal trauma) + peritoneal irritation signs + mobile turbid sounds.
Splenic rupture: (left abdominal trauma) + total abdominal pain + intra-abdominal hemorrhage.
Intestinal rupture: (mid-abdominal trauma) + peritoneal irritation sign + punctured yellowish fluid.
17, extra-abdominal hernia (hiatal hernia): elderly male + increased abdominal pressure + right lower abdominal mass + (into the scrotum)