Last reviewed: March 2020
Last updated: April
2018
Summary
Definition
History and exam
Key diagnostic factors
- colicky abdominal pain
- abdominal distention
- tympanic abdomen
- change in bowel habits
- hard feces
- empty rectum
- soft stools
- recent weight loss
- rectal bleeding
- abnormal bowel sounds
- palpable rectal mass
- palpable abdominal mass
- positive fecal occult blood test
- fever
- abdominal tenderness
- abdominal rigidity
Other diagnostic factors
- tenesmus
- history of radiotherapy
- history of gynecologic symptoms
- nausea and vomiting
- groin swelling
- pelvic mass
- ingestion of foreign body
Risk factors
- older age
- female gender
- institutionalization
- mental illness
- megacolon
- low or high dietary fiber
- previous colorectal resection
- previous abdominal surgery
- inflammatory bowel disease
- laxative abuse
- diabetes
Diagnostic investigations
1st investigations to order
- CBC
- serum electrolytes
- renal function
- serum amylase/lipase
- coagulation studies
- erect chest x-ray
- plain abdominal x-ray
Investigations to consider
- contrast enema
- CT abdomen and pelvis
- flexible/rigid endoscopy
- biopsy
Treatment algorithm
Contributors
Authors
Research Fellow
Department of Coloproctology
St Mark's Hospital
London
UK
Disclosures
GM declares that he has no competing interests.
Consultant Colorectal Surgeon
Department of Coloproctology
St. Mark's Hospital
London
UK
Disclosures
JTJ declares that he has no competing interests.
Dr George Malietzis and Dr John T. Jenkins would like to gratefully acknowledge Dr Alisdair J. MacDonald, a previous contributor to this topic. AJM declares that he has no competing interests.
Peer reviewers
Assistant Professor
Department of Surgery
University of Chicago
Chicago
IL
Disclosures
AF declares that he has no competing interests.
Consultant Surgeon
Crosshouse Hospital
Crosshouse
Kilmarnock
UK
Disclosures
RHD declares that he has no competing interests.
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