Steatorrhoea refers to the passing of excessive amounts of fat in the faeces. Causes Lipase deficiency ● Impaired secretion – chronic pancreatitis ● Inactivation – excess gastric acid Bile deficiency ● Underproduction – liver disease ● Obstruction – obstructive jaundice…
The spleen must be enlarged to about three times its normal size before it becomes clinically palpable. The lower margin may feel notched on palpation. The spleen may become so massive in size that it is palpable in the right…
Shock is an abnormality of the circulation that results in inadequate organ perfusion and tissue oxygenation. Causes (all causes of shock require emergency assessment) Hypovolaemic ● Haemorrhage ● Burns ● Gastrointestinal losses Cardiogenic ● Myocardial infarction ● Acute valvular damage…
Scrotal swellings are a common presenting complaint in the outpatient clinic. It is also important to distinguish between those swellings that have underlying serious pathology (testicular tumour) and those that are simple and benign (epididymal cysts). Causes ● Sebaceous cyst…
This may be due to lesions on the scrotal skin, within the scrotum, or may, rarely, be due to referred pain. It is important to make rapid diagnosis of emergencies, such as torsion and gangrene, and swiftly referred for surgery.…
Lesions on the scalp are common; the most common are sebaceous cysts, which are often multiple. Causes Traumatic ● Haematoma ● Cephalhaematoma Cystic ● Sebaceous cysts (epidermal cysts) ( Fig. 52 ) Neoplastic Benign ● Ivory osteoma Malignant Primary ●…
Rectal bleeding is a common symptom. The majority of patients with rectal bleeding have a simple condition such as haemorrhoids, but the symptoms should always be taken seriously and investigated. Rectal bleeding with a change in bowel habit or weight…
Most pyrexias result from a clearly defined illness, e.g. acute pyelonephritis or acute appendicitis, or from self-limiting viral infections, e.g. common cold. Pyrexia of unknown origin is defined as a temperature >38.3°C on several occasions, accompanied by more than three…
Pruritus ani is itching around the anal canal. It is a common symptom and in approximately half of the cases, no cause can be found. Causes Anal discharge ● Haemorrhoids ● Fistula-in-ano ● Skin tags ● Warts ( Fig. 50…
Pruritus is itching of the skin. There are a vast number of dermatological causes of pruritus, which are usually visible on inspection. However, the following are causes of generalised pruritus in the absence of skin disease. Causes ● Obstructive jaundice…