Essentials 1 Ischaemic strokes and transient ischaemic attacks (TIAs) are most commonly due to atherosclerotic thromboembolism of the cerebral vasculature or emboli from the heart. Other causes should be considered in younger patients, those presenting with atypical features or when…
Essentials 1 The pathophysiological basis of headache is understood to be traction or inflammation of extracranial structures, the basal dura or the large intracranial arteries and veins, dilatation/distension of cranial vascular structures or activation/sensitization of perivascular nerves. 2 Severity of…
Essentials 1 Anal pain, bleeding and masses are common symptoms in many different types of anorectal pathology. A careful history and anorectal examination are important in making the correct diagnosis. 2 Increasing fibre intake and reducing constipation are effective initial…
Essentials 1 Haematochezia is a common presentation in patients aged over 50 years and can result in shock due to large-volume blood loss. 2 The most common cause of lower gastrointestinal bleeding (LGIB) in younger patients (<50 years of age)…
Essentials 1 The diagnosis of acute liver failure (ALF) is based on the presence of worsening coagulopathy, hepatic encephalopathy and deepening jaundice. 2 In developing countries, viral causes predominate, with hepatitis E infection recognized as a common cause in many…
Essentials 1 The two major forms of inflammatory bowel disease (IBD) are Crohn’s disease and ulcerative colitis. The principal clinical features are diarrhoea and/or abdominal pain. 2 IBD is a chronic and relapsing condition. Patients may present to the emergency…
Essentials 1 Appendicitis is the commonest cause of acute abdominal pain requiring surgical treatment. 2 The diagnosis is primarily clinical, but the absence of a pathognomonic sign or conclusive first-line diagnostic test can cause diagnostic difficulty. 3 Diagnostic delay is…
Introduction The twin challenges of acute pancreatitis are to establish the diagnosis and stratify severity. The difficulty in diagnosing pancreatitis lies in its non-specific symptomatology, which is shared by a number of other gastrointestinal diseases. The 2012 revised Atlanta classification…
Essentials 1 More than 95% of biliary tract disease is attributable to gallstones. 2 Most patients with gallbladder disease present with abdominal pain. 3 Investigations are directed to confirming the diagnosis and detecting the presence of complications. 4 The management…
Essentials 1 Helicobacter pylori is responsible for 70% to 90% of peptic ulcers, with non-steroidal anti-inflammatory drugs (NSAIDs) accounting for most of the remainder. 2 Emergency presentations of peptic ulcer disease vary from mild indigestion to severe life-threatening complications. 3…