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Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
DISORDERS
March 19, 2022
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
DISORDERS
(Overview)
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
DISORDERS
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of
ABDOMINAL
DISORDERS – An
OVERVIEW. This is
part of the Health
Disorder Course.
Modules of ABDOMINAL DISORDER
COURSE
• Abdominal Disorders - Overview
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
• Gallbladder Disorder
• Hemorrhoids
• Abdominal Hernia
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Contents of ABDOMINAL DISORDERS
[OVERVIEW]
• What is an abdominal disorder?
• What are the different types of abdominal
disorders?
• What are the causes of abdominal disorders?
• How common are the abdominal disorders?
• Clinical diagnosis of abdominal disorders?
• Paraclinical diagnostic procedures for
abdominal disorders?
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Definition of Terms in Title AND Delimitation of
Coverage of Talk:
Fundamentals – simplest and essential facts and
theories which can serve as a basis or foundation
and support for advanced information
Generalities – general statements of info, not
covering specifics and details
Medical Management – diagnosis and treatment
by physicians
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
First, the meaning of DISORDER.
DISORDER is a definite disruption to regular
bodily structure and function but the specific
cause is not yet determined.
Once identified, the specific cause is called
the DISEASE.
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Second, the meaning of ABDOMEN.
ABDOMEN is the belly.
It has the abdominal wall and within it, is the
abdominal cavity, or body space.
The belly or abdomen is below the thorax (chest).
The diaphragm forms the upper surface of the
abdominal cavity. It serves as the boundary
between the abdominal cavity and the chest
cavity.
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Second, the meaning of ABDOMEN.
ABDOMEN is the belly.
In the abdominal cavity are various organs such as
the liver, gallbladder, stomach, small and large
intestines, pancreas, spleen, kidneys, urinary
bladder, uterus, ovaries, etc.
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
ABDOMINAL DISORDER is a DISORDER OF THE
ABDOMEN.
- definite disruption to regular bodily structure
and function of the belly (inclusive of the
abdominal wall and the organs inside the
abdominal cavity)
- but the specific cause is NOT yet determined.
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Thus, an ABDOMINAL DISORDER is a DISORDER of
the:
• Abdominal wall
• Organs and tissues within the abdominal cavity
• Liver
• Gallbladder
• Stomach
• Small and large intestines
• Spleen
• Pancreas
• Kidney
• Uterus / ovaries
• What is an abdominal disorder?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Once the specific cause of the ABDOMINAL
DISORDER is identified, then a diagnosis of a
DISEASE is given:
• Abdominal wall – e.g. Hernia, soft tissue sarcoma
• Liver – e.g. Hepatoma, cirrhosis
• Gallbladder – e.g. Gallbladder stones
• Stomach –e.g. Gastric ulcer, gastric cancer
• Small and large intestines – e.g. Enteritis, cancer
• Spleen – e.g. Hematological splenomegaly, cancer
• Pancreas – e.g. Pancreatitis, pancreatic cancer
• Kidney – e.g. Kidney stones, cancer
• Uterus / ovaries – e.g. Myoma, ovarian cancer
• What are the different types of abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• What are the different types of abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
DISORDERS with VARIOUS SPECIFIC CAUSES!
• What are the different types of abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Abdominal Pain – SAKIT NG TIYAN
• Abdominal Mass – BUKOL SA TIYAN
• Abdominal Obstruction – BARADO SA BITUKA
O TUBO SA TIYAN
• Abdominal Bleeding – DUGO SA O GALING SA
TIYAN
• Jaundice – PANINILAW NG MATA NA
APEKTADO ANG ATAY
DISORDERS with VARIOUS SPECIFIC CAUSES!
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
CAUSES
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES – PAIN FROM
TRAUMA
NON-TRAUMA
• Abdominal MASS – different subcauses
• Abdominal OBSTRUCTION different
subcauses
• Abdominal BLEEDING – different
subcauses
• JAUNDICE – different subcauses
DISORDERS
• Abdominal Pain (SAKIT
NG TIYAN)
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
DISORDERS
• Abdominal Pain
• Abdominal Mass
(BUKOL SA TIYAN)
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Abdominal MASS – originating from the
belly (abdominal WALL and ORGANS /
TISSUES within abdominal CAVITY)
• Cancers
• Non-cancers
• Abscess
DISORDERS
• Abdominal Pain
• Abdominal Mass
(BUKOL SA TIYAN)
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the abdominal cavity that
channel fluid or foods can be obstructed.
Examples:
• Stomach
• Small intestines
• Large intestines
• Hepatobiliary tree or duct
• Ureters
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the
abdominal cavity that
channel fluid or foods
can be obstructed.
Examples:
• Stomach
• Small intestines
• Large intestines
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the
abdominal cavity
that channel fluid
or foods can be
obstructed.
Examples:
• Hepatobiliary
tree
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the
abdominal cavity
that channel fluid
or foods can be
obstructed.
Examples:
• Ureters
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the abdominal cavity that
channel fluid or foods can be obstructed.
Abdominal obstruction can be caused by:
• Cancers
• Non-cancers
• Benign tumors
• Adhesions
• Intussusception
• Abscess
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the abdominal cavity
that channel fluid or foods can be
obstructed.
Abdominal obstruction can be caused
by:
• Cancers
• Non-cancers
• Benign tumors
• Tumors
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the abdominal cavity that
channel fluid or foods can be obstructed.
Abdominal obstruction can be caused by:
• Cancers
• Non-cancers
• Benign tumors
• Adhesions
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Any tubes in the abdominal cavity that
channel fluid or foods can be obstructed.
Abdominal obstruction can be caused by:
• Cancers
• Non-cancers
• Benign tumors
• Adhesions
• Intussusception
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
(BARADO SA BITUKA O
TUBO SA TIYAN)
• Abdominal Bleeding
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Abdominal BLEEDING – originating from
the belly (abdominal WALL and ORGANS /
TISSUES within abdominal CAVITY)
• TRAUMA
• NON-TRAUMA
• Cancers
• Non-cancers
• Benign tumors
• Ulcers / Hemorrhoids
• Infections
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
(DUGO SA O GALING SA
TIYAN)
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Gastrointestinal BLEEDING – originating
from GASTROINTESTINAL TRACT in the
abdomen
• Upper GI Bleeding (upper part – usually
stomach and duodenum)
• Lower GI Bleeding (lower part – rectum,
colon, ileum, jejunum)
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
(DUGO SA O GALING SA
TIYAN)
• Jaundice
• What are the causes of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
CAUSES
Jaundice – different causes
• Liver disease
• Biliary tree disease
• Cancers
• Non-cancer tumors
• Cirrhosis
• Stones
DISORDERS
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice (PANINILAW
NG MATA NA
APEKTADO ANG ATAY)
• How common are the abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• How common are the abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Abdominal Pain – most common
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
Common
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
Start with identifying the DISORDER based on
symptoms and signs.
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
DISORDER
SPECIFIC CAUSE
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
Then look for cues for a SPECIFIC CAUSE or
DISEASE causing the DISORDER.
Use PATTERN RECOGNITION of a particular
disease and PREVALENCE process in those with
similar presentation of symptoms and signs.
DISORDER
SPECIFIC CAUSE
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EVALUATION METHODS:
• HISTORY TAKING – TO GET SYMPTOMS
• PHYSICAL EXAMINATION – TO GET SIGNS
CLINICAL DIAGNOSIS
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EVALUATION METHODS:
• HISTORY TAKING – TO GET SYMPTOMS
• PHYSICAL EXAMINATION – TO GET SIGNS
CLINICAL DIAGNOSIS
Basic data needed in
HISTORY:
• When initial
symptoms noted
• Subsequent
course
• Associated
symptoms
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EVALUATION METHODS:
• HISTORY TAKING – TO GET SYMPTOMS
• PHYSICAL EXAMINATION – TO GET SIGNS
CLINICAL DIAGNOSIS
Basic data needed in
EXAMINATION:
LOOK and PALPATE
• Look for bulge
• Look for
distention
• Palpate for mass
• Palpate for
tenderness
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EXAMINATION OF THE ABDOMEN:
LOOK AND PALPATE
• LOOK for unusual bulge that may suggest
mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction, mass or fluid.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, location and severity.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EXAMINATION OF THE ABDOMEN:
LOOK AND PALPATE
• LOOK for unusual bulge that may suggest
mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction, mass or fluid.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, location and severity.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EXAMINATION OF THE ABDOMEN:
LOOK AND PALPATE
• LOOK for unusual bulge that may suggest
mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction, mass or fluid.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, location and severity.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
BASIC EXAMINATION OF THE ABDOMEN:
LOOK AND PALPATE
• LOOK for unusual bulge that may suggest
mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction, mass or fluid.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, location and severity.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
ABDOMINAL PAIN – use LOCATION to suspect the
possible organ of concern.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
ABDOMINAL PAIN – ask and use NATURE OF PAIN
to suspect the possible organ of concern –
whether HOLLOW OR SOLID ORGANS are
involved.
CRAMPY abdominal pain – usually hollow organ
involvement like gallbladder, stomach, intestines,
etc.
NOT CRAMPY – usually solid organs or peritonitis
(inflammation of the lining of abdomen)
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
ABDOMINAL MASS – use LOCATION to suspect
the possible organ of concern.
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
GASTROINTESTINAL OBSTRUCTION –
CUES: abdominal pain, vomiting, abdominal
distention, and no bowel movement
• Palpate for a MASS as a possible cause and
location of obstruction
• If no MASS, consider adhesions in patients
with history of abdominal operation
• Use color of vomitus as cues for site of
obstruction – not yellow/green = stomach level
and up; yellow/green = below the stomach
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
GASTROINTESTINAL BLEEDING –
CUES: vomiting of frank blood; passage of frank
blood per anus; black stools per anus
• Palpate for a MASS as a possible cause
• If no mass, use the color of vomitus and stools
as cues:
• Upper GI Bleeding – vomiting of frank
blood; black stools per anus
• Lower GI Bleeding – passage of frank blood
per anus
• Clinical diagnosis of abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
TIPS:
JAUNDICE
CUE: yellowing of the eyes (the white part)
• Palpate for a MASS in the LIVER as a possible
cause.
• If no mass, look for symptoms suggestive of
hepatitis, gallbladder disease (with stones in
the biliary passage) or pancreatic disease.
• Paraclinical diagnostic procedures for
abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Paraclinical diagnostic procedures for
abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Common instrumental and laboratory diagnostic
procedures for ABDOMINAL DISORDER:
• Imaging procedures (x-rays – plain / with
barium dye; ultrasound; CT scan; MRI; PET
scan; etc.)
• Endoscopy (upper - esophagogastroscopy /
lower – colonoscopy, sigmoidoscopy,
proctoscopy)
• Blood tests (CBC; liver function tests; hepatitis
profile; tumor markers; etc.)
• Paraclinical diagnostic procedures for
abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Competencies required of physicians managing
abdominal disorders:
• Know the uses and indications of all known
instrumental and laboratory diagnostic
procedures for abdominal disorders.
• Use as needed and indicated.
• Select the most cost-effective one using the
BRCA process.
• Know how to interpret the results.
• Paraclinical diagnostic procedures for
abdominal disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
BRCA Process in selecting diagnostic procedures
Procedures Benefit
(goal – to
be more
definite on
the
diagnosis)
Risk Cost Availability
Option1
Option2
Option3
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
DISORDERS SPECIFIC DISEASE SURGICAL / NON-SURGICAL*
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no intervention)
• Potentially surgical – surgical only when needed
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
DISORDERS SPECIFIC DISEASE SURGICAL / NON-SURGICAL*
Examples of Surgical Abdomen
• Abdominal Pain PERITONITIS
• Abdominal Mass OPERABLE CANCER
• Abdominal Obstruction OBSTRUCTION BY TUMOR
• Abdominal Bleeding TUMOR BLEEDING
• Jaundice OBSTRUCTIVE JAUNDICE -STONE
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no intervention)
• Potentially surgical – surgical only when needed
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
BRCA Process in selecting cost-effective treatment
modality.
Contents of ABDOMINAL DISORDERS
[OVERVIEW]
• What is an abdominal disorder?
• What are the different types of abdominal
disorders?
• What are the causes of abdominal disorders?
• How common are the abdominal disorders?
• Clinical diagnosis of abdominal disorders?
• Paraclinical diagnostic procedures for
abdominal disorders?
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Summary
Take Away
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
DISORDERS
Be always in touch with reliable medical
information on fundamentals and
generalities in medical management of
ABDOMINAL DISORDERS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of ABDOMINAL
DISORDERS.
Take Away in
relation to
Patient
Empowerment
Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
DISORDERS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
DISORDERS
March 19, 2022
1400H - 1500H
Via Zoom

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ROJoson PEP Talk: ABDOMINAL DISORDERS - An Overview

  • 1. Empowerment objective - for laypeople to have an understanding of the FUNDAMENTALS and GENERALITIES in the MEDICAL MANAGEMENT of ABDOMINAL DISORDERS. Health Disorder Course– Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS March 19, 2022 1400H - 1500H Via Zoom
  • 2. Empowerment objective - for laypeople to have an understanding of the FUNDAMENTALS and GENERALITIES in the MEDICAL MANAGEMENT of ABDOMINAL DISORDERS. Health Disorder Course– Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS (Overview) ROJoson PEP Talk I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.
  • 3. There are 3 courses in the PEP Talk. I completed the Core Course on October 9, 2021.
  • 4. From October 23, 2021 onwards, I have been tackling Health Disorder and Health Issue Courses. This may take 3 years or longer.
  • 5. Empowerment objective - for laypeople to have an understanding of the FUNDAMENTALS and GENERALITIES in the MEDICAL MANAGEMENT of ABDOMINAL DISORDERS. Health Disorder Course– Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS My PEP TALK today is entitled: Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS – An OVERVIEW. This is part of the Health Disorder Course.
  • 6. Modules of ABDOMINAL DISORDER COURSE • Abdominal Disorders - Overview • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice • Gallbladder Disorder • Hemorrhoids • Abdominal Hernia Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 7. Contents of ABDOMINAL DISORDERS [OVERVIEW] • What is an abdominal disorder? • What are the different types of abdominal disorders? • What are the causes of abdominal disorders? • How common are the abdominal disorders? • Clinical diagnosis of abdominal disorders? • Paraclinical diagnostic procedures for abdominal disorders? • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 8. Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Definition of Terms in Title AND Delimitation of Coverage of Talk: Fundamentals – simplest and essential facts and theories which can serve as a basis or foundation and support for advanced information Generalities – general statements of info, not covering specifics and details Medical Management – diagnosis and treatment by physicians
  • 9. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 10. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS First, the meaning of DISORDER. DISORDER is a definite disruption to regular bodily structure and function but the specific cause is not yet determined. Once identified, the specific cause is called the DISEASE.
  • 11. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Second, the meaning of ABDOMEN. ABDOMEN is the belly. It has the abdominal wall and within it, is the abdominal cavity, or body space. The belly or abdomen is below the thorax (chest). The diaphragm forms the upper surface of the abdominal cavity. It serves as the boundary between the abdominal cavity and the chest cavity.
  • 12. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Second, the meaning of ABDOMEN. ABDOMEN is the belly. In the abdominal cavity are various organs such as the liver, gallbladder, stomach, small and large intestines, pancreas, spleen, kidneys, urinary bladder, uterus, ovaries, etc.
  • 13. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS ABDOMINAL DISORDER is a DISORDER OF THE ABDOMEN. - definite disruption to regular bodily structure and function of the belly (inclusive of the abdominal wall and the organs inside the abdominal cavity) - but the specific cause is NOT yet determined.
  • 14. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Thus, an ABDOMINAL DISORDER is a DISORDER of the: • Abdominal wall • Organs and tissues within the abdominal cavity • Liver • Gallbladder • Stomach • Small and large intestines • Spleen • Pancreas • Kidney • Uterus / ovaries
  • 15. • What is an abdominal disorder? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Once the specific cause of the ABDOMINAL DISORDER is identified, then a diagnosis of a DISEASE is given: • Abdominal wall – e.g. Hernia, soft tissue sarcoma • Liver – e.g. Hepatoma, cirrhosis • Gallbladder – e.g. Gallbladder stones • Stomach –e.g. Gastric ulcer, gastric cancer • Small and large intestines – e.g. Enteritis, cancer • Spleen – e.g. Hematological splenomegaly, cancer • Pancreas – e.g. Pancreatitis, pancreatic cancer • Kidney – e.g. Kidney stones, cancer • Uterus / ovaries – e.g. Myoma, ovarian cancer
  • 16. • What are the different types of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 17. • What are the different types of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice DISORDERS with VARIOUS SPECIFIC CAUSES!
  • 18. • What are the different types of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS • Abdominal Pain – SAKIT NG TIYAN • Abdominal Mass – BUKOL SA TIYAN • Abdominal Obstruction – BARADO SA BITUKA O TUBO SA TIYAN • Abdominal Bleeding – DUGO SA O GALING SA TIYAN • Jaundice – PANINILAW NG MATA NA APEKTADO ANG ATAY DISORDERS with VARIOUS SPECIFIC CAUSES!
  • 19. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 20. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice CAUSES
  • 21. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES – PAIN FROM TRAUMA NON-TRAUMA • Abdominal MASS – different subcauses • Abdominal OBSTRUCTION different subcauses • Abdominal BLEEDING – different subcauses • JAUNDICE – different subcauses DISORDERS • Abdominal Pain (SAKIT NG TIYAN) • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice
  • 22. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS DISORDERS • Abdominal Pain • Abdominal Mass (BUKOL SA TIYAN) • Abdominal Obstruction • Abdominal Bleeding • Jaundice
  • 23. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Abdominal MASS – originating from the belly (abdominal WALL and ORGANS / TISSUES within abdominal CAVITY) • Cancers • Non-cancers • Abscess DISORDERS • Abdominal Pain • Abdominal Mass (BUKOL SA TIYAN) • Abdominal Obstruction • Abdominal Bleeding • Jaundice
  • 24. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Examples: • Stomach • Small intestines • Large intestines • Hepatobiliary tree or duct • Ureters DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 25. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Examples: • Stomach • Small intestines • Large intestines DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 26. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Examples: • Hepatobiliary tree DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 27. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Examples: • Ureters DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 28. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Abdominal obstruction can be caused by: • Cancers • Non-cancers • Benign tumors • Adhesions • Intussusception • Abscess DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 29. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Abdominal obstruction can be caused by: • Cancers • Non-cancers • Benign tumors • Tumors DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 30. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Abdominal obstruction can be caused by: • Cancers • Non-cancers • Benign tumors • Adhesions DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 31. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Any tubes in the abdominal cavity that channel fluid or foods can be obstructed. Abdominal obstruction can be caused by: • Cancers • Non-cancers • Benign tumors • Adhesions • Intussusception DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction (BARADO SA BITUKA O TUBO SA TIYAN) • Abdominal Bleeding • Jaundice
  • 32. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Abdominal BLEEDING – originating from the belly (abdominal WALL and ORGANS / TISSUES within abdominal CAVITY) • TRAUMA • NON-TRAUMA • Cancers • Non-cancers • Benign tumors • Ulcers / Hemorrhoids • Infections DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding (DUGO SA O GALING SA TIYAN) • Jaundice
  • 33. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Gastrointestinal BLEEDING – originating from GASTROINTESTINAL TRACT in the abdomen • Upper GI Bleeding (upper part – usually stomach and duodenum) • Lower GI Bleeding (lower part – rectum, colon, ileum, jejunum) DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding (DUGO SA O GALING SA TIYAN) • Jaundice
  • 34. • What are the causes of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS CAUSES Jaundice – different causes • Liver disease • Biliary tree disease • Cancers • Non-cancer tumors • Cirrhosis • Stones DISORDERS • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice (PANINILAW NG MATA NA APEKTADO ANG ATAY)
  • 35. • How common are the abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 36. • How common are the abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS • Abdominal Pain – most common • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice Common
  • 37. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 38. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: Start with identifying the DISORDER based on symptoms and signs. • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice DISORDER SPECIFIC CAUSE
  • 39. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: Then look for cues for a SPECIFIC CAUSE or DISEASE causing the DISORDER. Use PATTERN RECOGNITION of a particular disease and PREVALENCE process in those with similar presentation of symptoms and signs. DISORDER SPECIFIC CAUSE
  • 40. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EVALUATION METHODS: • HISTORY TAKING – TO GET SYMPTOMS • PHYSICAL EXAMINATION – TO GET SIGNS CLINICAL DIAGNOSIS
  • 41. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EVALUATION METHODS: • HISTORY TAKING – TO GET SYMPTOMS • PHYSICAL EXAMINATION – TO GET SIGNS CLINICAL DIAGNOSIS Basic data needed in HISTORY: • When initial symptoms noted • Subsequent course • Associated symptoms
  • 42. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EVALUATION METHODS: • HISTORY TAKING – TO GET SYMPTOMS • PHYSICAL EXAMINATION – TO GET SIGNS CLINICAL DIAGNOSIS Basic data needed in EXAMINATION: LOOK and PALPATE • Look for bulge • Look for distention • Palpate for mass • Palpate for tenderness
  • 43. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EXAMINATION OF THE ABDOMEN: LOOK AND PALPATE • LOOK for unusual bulge that may suggest mass. • LOOK for abdominal distention that may suggest intestinal obstruction, mass or fluid. • PALPATE for possible presence of mass. • PALPATE for presence of tenderness (pain on pressure) – if present, location and severity.
  • 44. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EXAMINATION OF THE ABDOMEN: LOOK AND PALPATE • LOOK for unusual bulge that may suggest mass. • LOOK for abdominal distention that may suggest intestinal obstruction, mass or fluid. • PALPATE for possible presence of mass. • PALPATE for presence of tenderness (pain on pressure) – if present, location and severity.
  • 45. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EXAMINATION OF THE ABDOMEN: LOOK AND PALPATE • LOOK for unusual bulge that may suggest mass. • LOOK for abdominal distention that may suggest intestinal obstruction, mass or fluid. • PALPATE for possible presence of mass. • PALPATE for presence of tenderness (pain on pressure) – if present, location and severity.
  • 46. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: BASIC EXAMINATION OF THE ABDOMEN: LOOK AND PALPATE • LOOK for unusual bulge that may suggest mass. • LOOK for abdominal distention that may suggest intestinal obstruction, mass or fluid. • PALPATE for possible presence of mass. • PALPATE for presence of tenderness (pain on pressure) – if present, location and severity.
  • 47. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: ABDOMINAL PAIN – use LOCATION to suspect the possible organ of concern.
  • 48. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: ABDOMINAL PAIN – ask and use NATURE OF PAIN to suspect the possible organ of concern – whether HOLLOW OR SOLID ORGANS are involved. CRAMPY abdominal pain – usually hollow organ involvement like gallbladder, stomach, intestines, etc. NOT CRAMPY – usually solid organs or peritonitis (inflammation of the lining of abdomen)
  • 49. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: ABDOMINAL MASS – use LOCATION to suspect the possible organ of concern.
  • 50. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: GASTROINTESTINAL OBSTRUCTION – CUES: abdominal pain, vomiting, abdominal distention, and no bowel movement • Palpate for a MASS as a possible cause and location of obstruction • If no MASS, consider adhesions in patients with history of abdominal operation • Use color of vomitus as cues for site of obstruction – not yellow/green = stomach level and up; yellow/green = below the stomach
  • 51. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: GASTROINTESTINAL BLEEDING – CUES: vomiting of frank blood; passage of frank blood per anus; black stools per anus • Palpate for a MASS as a possible cause • If no mass, use the color of vomitus and stools as cues: • Upper GI Bleeding – vomiting of frank blood; black stools per anus • Lower GI Bleeding – passage of frank blood per anus
  • 52. • Clinical diagnosis of abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS TIPS: JAUNDICE CUE: yellowing of the eyes (the white part) • Palpate for a MASS in the LIVER as a possible cause. • If no mass, look for symptoms suggestive of hepatitis, gallbladder disease (with stones in the biliary passage) or pancreatic disease.
  • 53. • Paraclinical diagnostic procedures for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 54. • Paraclinical diagnostic procedures for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Common instrumental and laboratory diagnostic procedures for ABDOMINAL DISORDER: • Imaging procedures (x-rays – plain / with barium dye; ultrasound; CT scan; MRI; PET scan; etc.) • Endoscopy (upper - esophagogastroscopy / lower – colonoscopy, sigmoidoscopy, proctoscopy) • Blood tests (CBC; liver function tests; hepatitis profile; tumor markers; etc.)
  • 55. • Paraclinical diagnostic procedures for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Competencies required of physicians managing abdominal disorders: • Know the uses and indications of all known instrumental and laboratory diagnostic procedures for abdominal disorders. • Use as needed and indicated. • Select the most cost-effective one using the BRCA process. • Know how to interpret the results.
  • 56. • Paraclinical diagnostic procedures for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS BRCA Process in selecting diagnostic procedures Procedures Benefit (goal – to be more definite on the diagnosis) Risk Cost Availability Option1 Option2 Option3
  • 57. • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS
  • 58. • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS DISORDERS SPECIFIC DISEASE SURGICAL / NON-SURGICAL* • Abdominal Pain • Abdominal Mass • Abdominal Obstruction • Abdominal Bleeding • Jaundice • Surgical – outright surgical • Non-surgical – non-surgical at all times (no intervention) • Potentially surgical – surgical only when needed
  • 59. • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS DISORDERS SPECIFIC DISEASE SURGICAL / NON-SURGICAL* Examples of Surgical Abdomen • Abdominal Pain PERITONITIS • Abdominal Mass OPERABLE CANCER • Abdominal Obstruction OBSTRUCTION BY TUMOR • Abdominal Bleeding TUMOR BLEEDING • Jaundice OBSTRUCTIVE JAUNDICE -STONE • Surgical – outright surgical • Non-surgical – non-surgical at all times (no intervention) • Potentially surgical – surgical only when needed
  • 60. • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS BRCA Process in selecting cost-effective treatment modality.
  • 61. Contents of ABDOMINAL DISORDERS [OVERVIEW] • What is an abdominal disorder? • What are the different types of abdominal disorders? • What are the causes of abdominal disorders? • How common are the abdominal disorders? • Clinical diagnosis of abdominal disorders? • Paraclinical diagnostic procedures for abdominal disorders? • Basic treatment modalities for abdominal disorders? Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Summary Take Away
  • 62. Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS Be always in touch with reliable medical information on fundamentals and generalities in medical management of ABDOMINAL DISORDERS. Knowledge is power; it gives power. Use the 4Ks of Patient Empowerment: Kaalaman, Kakayanan, Karapatan and Kapangyarihan to gain greater control over decisions in medical management of ABDOMINAL DISORDERS. Take Away in relation to Patient Empowerment
  • 63. Empowerment objective - for laypeople to have an understanding of the FUNDAMENTALS and GENERALITIES in the MEDICAL MANAGEMENT of ABDOMINAL DISORDERS. Health Disorder Course– Fundamentals and Generalities in Medical Management of ABDOMINAL DISORDERS March 19, 2022 1400H - 1500H Via Zoom