Presentation Recurring, unpredictable, clonic contractions of the diaphragm that produce sharp inhalations are known as singultus or more commonly as hiccups. Hiccups are usually precipitated by some combination of laughing, talking, eating, and drinking but may also occur spontaneously. Most…
Presentation Patients with external hemorrhoids ( Fig. 74.1 ) generally complain of a painful anal lump of sudden onset, which may become intense in severity. This type of pain, in most instances, represents a thrombosed hemorrhoid, which will appear to…
Presentation Parents bring in a young child (usually between the ages of 6 months and 6 years) shortly after the child has swallowed a coin, safety pin, or toy. The child may be asymptomatic or have recurrent or transient symptoms…
Presentation Rectal foreign bodies may present with abdominal pain, anorectal pain, obstipation, acute urinary retention, or blood or mucous discharge from the rectum. Such foreign bodies are often difficult to diagnose because the history may not be offered by the…
Presentation The patient develops symptoms either immediately after swallowing a large mouthful of food (usually inadequately chewed meat) or as the result of intoxication, wearing dentures, or being too embarrassed to spit out a large piece of gristle. The patient…
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Presentation Complaints may range from occasional stool that is not well formed to acute, copious diarrhea that produces profound dehydration and shock. Patients with inflammatory or infectious diarrhea often present with fever, tenesmus (the frequent urge to defecate), abdominal pain,…
Presentation Patients with functional constipation will often come in with the complaint of abdominal pain or bloating. Often it is not until they are asked that they will describe infrequent bowel movements, straining at stooling, incomplete evacuation, hard or small…
Presentation The patient presents complaining of a gastrostomy tube (G-tube) or jejunostomy tube (J-tube) that is not functioning properly. The most common complaints are that the tube is obstructed, leaking, displaced, or that there is pain and/or redness surrounding the…
Presentation In most patients, the symptoms are so characteristic that they are nearly diagnostic. Initial onset of pain often occurs during or after defecation, usually after passing a large, hard bowel movement or following an explosive bout of diarrhea. Later,…