Abdominal Distention - Differential Diagnostic Algorithm

Ascites

Bowel Dilatation

Other Causes

Mechanical Obstruction

 • Adhesions 60%

 • Volvulus 3%

 • Malignancy 20%

 • Herniation 10%

Pseudo-obstruction

Acute Colonic

Paralytic Ileus

 • Peritonitis

 • Post-surgical

 • Hypothyroidism

Chronic Intestinal

Ogilvie's Syndrome

 • Trauma/Surgery

 • Medical Conditions (e.g. Myocardial Infarction, Congestive Heart Failure)

 • Drugs

 • Retroperitoneal Hemorrhage/Malignancy

Toxic Megacolon

 • Inflammatory

 • Infectious

 • Ischemic

Myopathic

 • Scleroderma

 • Familial Myopathy

Neuropathic

 • Enteric (e.g. Amyloidosis, Paraneoplastic, Narcotics)

 • Extrinsic (e.g. Multiple Sclerosis, Spinal Injury, Stroke)



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