趨勢走向

09/11/2025

✅ Abdominal Pain – Easy Guide

Abdominal pain can be understood by location. Each region suggests specific causes.

✅ Upper Abdomen

🔹 Epigastric (middle upper)

Common stomach & heart-related causes:
• Gastritis
• GERD
• Peptic ulcer disease (PUD)
• Pancreatitis
• Heart attack (MI)
• Esophagitis
• Pericarditis
• Ruptured AAA (dangerous)

🔹 Right Upper Quadrant (RUQ)

Mostly liver & gallbladder:
• Gallstones / Biliary colic
• Cholecystitis
• Cholangitis
• Hepatitis
• Pancreatitis
• Liver abscess
• Budd–Chiari (rare)

🔹 Left Upper Quadrant (LUQ)

Mostly spleen & stomach:
• Splenic infarct / rupture
• Splenic abscess
• Gastritis
• Peptic ulcer
• Pancreatitis
• Sub-diaphragmatic abscess

✅ Middle Abdomen

🔹 Periumbilical (around belly button)

Gut-related:
• Early appendicitis
• Gastroenteritis
• Small bowel obstruction
• IBS/IBD
• Ruptured AAA (dangerous)

🔹 Right Lumbar
• Kidney stones
• Pyelonephritis (kidney infection)
• Perinephric abscess

🔹 Left Lumbar

Same as right:
• Kidney stones
• Pyelonephritis
• Perinephric abscess

✅ Lower Abdomen

🔹 Right Lower Quadrant (RLQ)

The classic:
• Appendicitis
• Ectopic pregnancy
• Ovarian issues
• Hernia
• Nephrolithiasis
• IBS/IBD
• Cecal volvulus

🔹 Suprapubic / Hypogastrium

Bladder, uterus, or bowel:
• UTI / cystitis
• Urinary retention
• IBS/IBD
• Ovarian cyst

🔹 Left Lower Quadrant (LLQ)

Colon & reproductive:
• Diverticulitis
• Ectopic pregnancy
• Salpingitis
• IBS/IBD
• Nephrolithiasis
• Sigmoid volvulus

✅ Diffuse Abdominal Pain (all over)

These affect the entire abdomen:
• Gastroenteritis
• SBO (small bowel obstruction)
• Mesenteric ischemia
• Peritonitis
• IBS/IBD
• Diabetes (DKA)
• Functional or psychiatric causes
• Familial Mediterranean fever

✅ Chronic Pain
• IBS / IBD
• Dyspepsia
• Lactose intolerance
• Endometriosis
• Hernia
• Cancer (GI, GYN)

08/11/2025

Blood Compatibility

Please What's your blood group? I rep A+

08/11/2025

Uterine Leiomyoma (Fibroid)

Definition:
Uterine leiomyomas are benign smooth muscle tumors of the uterus, composed mainly of fibrous connective tissue. They are the most common pelvic tumors in women and are hormonally responsive to estrogen and progesterone .

Symptoms:
Most cases are asymptomatic, but when present, symptoms include:
• Abnormal uterine bleeding (menorrhagia, intermenstrual bleeding)
• Pelvic pressure or pain
• Increased urinary frequency or constipation (due to mass effect)
• Infertility or recurrent miscarriage
• Palpable pelvic mass

Diagnosis:
• Pelvic examination: May reveal enlarged, irregular uterus.
• Imaging: Transvaginal or pelvic ultrasound is the first-line imaging; saline infusion sonohysterography or MRI may be used to define submucosal or intramural fibroids and exclude malignancy (e.g., leiomyosarcoma) .
• Endometrial biopsy: Indicated for women >40 years or with risk factors to rule out hyperplasia or carcinoma .

Differential Diagnosis:
• Adenomyosis
• Endometrial polyps
• Endometrial carcinoma
• Ovarian mass

Treatment:
Management depends on symptoms, size, and fertility wishes:
• Medical therapy:
• Hormonal options (OCPs, progestins, GnRH agonists/antagonists) to reduce bleeding and size.
• Nonhormonal: NSAIDs and antifibrinolytics for pain and bleeding control .
• Surgical options:
• Myomectomy – preferred for women desiring fertility.
• Uterine artery embolization or laparoscopic radiofrequency ablation for uterine-sparing alternatives.
• Hysterectomy – definitive and curative for those not desiring future fertility .

Complications and Follow-up:
• Iron deficiency anemia due to heavy bleeding
• Acute hemorrhage or severe pain from degeneration
• Rarely, prolapse of submucosal fibroid through the cervix
• May obscure other gynecologic malignancies 
• In pregnancy: miscarriage, preterm labor, malpresentation, or dystocia 

Follow-up:
Monitor for recurrence or regrowth, anemia status, and assess symptom control post-therapy. Postmenopausal growth warrants evaluation for malignancy .

08/11/2025