Abdominal pain নিয়ে যত কথা:
এবার জানি কোন area তে কি হয়:
1. epigastric pain—PUD, acute pancreatitis
2. lower abdominal pain UTI , PID (Pelvic inflammatory disease)
3. loin pain –pyelonephritis, renal stone
4. right iliac fossa -appendicitis
5. right upper abdomen –liver abscess and acute cholecystaitis
6. 1. diffuse pain –peritonitis.
কোনটা কখন শুরু হয়:
1. sudden –acute abdomen
2. insidious / gradual –chronic pain 3. intermittent –PUD, chronic pancreatitis
pain এর character কেমন:
1. burning is pud
2. spasmodic / colicky /cramping –obstruction,stone
কোনটা কোথায় Radiate করে:
1. back –pancreatitis
2. right shoulder –acute cholecystitis
3. left shoulder –splenic infarction 4. loin to goin –uteric stone
Others কোন Associated আছে কিনা :
1. vomiting –pud , acute abdomen 2. fever —infective causes /
3. diarrhea / alteration of bowel habit, TB,IBS, malignancy
4.Diarrhoea -IBD
Exacerbating relieving factor associated কিনা:
1.empty stomach –pud
2.Alcohol/ after fatty meal —chronic pancreatitis
3.after meal—pancreatitis , ischaemic pain , IBD relieving factor 4.after food/ antacid —PUD
5.bending forward –acute pancreatic
6.vomitting —PUD/GERD
সাথে Timing and duration
আর severity and intensity, history নিতে হবে।
পুনশ্চ:যেকোন রোগ ডায়াগনোসিস এর মেইন key হচ্ছে proper history. তাই
হিস্টোরি নেবার সময় দার্শনিক “SOCRATES”কে খুব ভালভাবে মনে রাখতে হবে। That means,
Site,Onset,Character,Radiation, aggravating factor,Timing and duration,Exacerbating relieving factor,Severity and intensity.
Raiyyan Tahsan. Date:04-11-24.munday,
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