This document provides tips for using a PowerPoint presentation (PPT) for active learning sessions: 1. The PPT can be freely downloaded, edited, and modified. 2. Many slides are intentionally blank except for the title to facilitate discussion. The instructor should show blank slides, ask students what they know about the topic, and then show the content slide. 3. This process of blank slide + student input + content slide should be repeated for each topic across three revisions for optimal active learning. The PPT can also be used for self-study. 4. The notes section includes bibliographic references.

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Regions of Abdomen

3. How to Diagnose

4. How to Diagnose
• History
• Physical Examination
• Investigations
• Laparotomy
• Histpathology

5. History

6. History
• Age
• Sex
• Pain
• Vomitings
• Motions
• Urination
• Fever

7. Physical Examination

8. Physical Examination
• General
• Systemic
• Local

9. General Physical Examination

10. General Physical Examination
• Appearance:
• emaciated
• Anemic,
• jaundiced or
• Lymph nodes, especially supraclavicular.

11. Per Abdomen

12. Per Abdomen
• Eyes first and the most
• Hands next
• Tongue not at all

13. Per Abdomen
• Inspection
• Palpation
• Percussion
• Auscultation

14. Inspection

15. Inspection
• Abdominal distension
• Visible peristalsis
• Overlying skin
• Position, size, shape and surface of the
swelling
• Movement of swelling on respiration
• Check sites of hernia
• Observe scrotum for any fullness

16. Palpation

17. Palpation
• Whole abdomen soft or rigid
• Tenderness

18. Palpation of Lump

19. Palpation of Lump
• local temperature
• Tenderness
• Confirming positive findings of inspection
• Margins
• Consistency: Soft, firm or hard uniform or
variegated
• Mobility:
• Level : Is swelling parietal or intra-
abdominal?

20. • Percussion:
– Dull or resonant
– Fluid thrill
• Auscultation:
– For rub (perisplenitis and perihepatitis)

21. Investigations

22. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histlogy

23. Diagnostic Studies

24. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• ERCP
• MRI
• Nuclear scan

25. Other Studies

26. Other Studies
• Endoscopy
• Endosonography(EUS)

27. D/D

28. D/D
• Swellings in the Abdominal Wall
– Sebaceous Cyst
– Lipoma
– Parietal wall abscess

29. D/D Intra-abdominal Swellings
c
s

30. D/D Intra-abdominal Swellings
• Hepatic
• Gall Bladder
• Sub-Phrenic Abscess
• Stomach and Duodenum
• Hepatic Flexure of Colon
• Right Kidney
• Right Suprarenal
c
s

31. Hepatic

32. Hepatic
• 1. It moves with respiration but is not
mobile sideways
2. The swelling is continuous with the liver
dullness without a band of colonic
resonance

33. Hepatic swellings
• Amoebic abscess
• Pyogenic abscess
• Riedel’s lobe
• Hydatid cyst
• Hepatoma
• Secondaries
• Cirrhosis

34. Sub-Phrenic Abscess

35. Sub-Phrenic Abscess
1 Pain in the right hypochondrial region
referred to the shoulders
2. Diffuse tender swelling in the right
hypochondrial region
3. Signs of septicemia: High fever with
rigors, sweating and marked tachycardia
4. Screening: Raised and fixed diaphragm
with gas under it
5. Features of the causative condition e.g.
perforated peptic ulcer, liver abscess

36. Gall Bladder

37. Gall Bladder
1. Oval smooth swelling, the size of an egg
2. Moves with respiration,
• Ca Gall bladder
• Ca. Head of pancreas
• Mucocele
• Choledochus cyst

38. Stomach and Duodenum

39. Stomach and Duodenum
• Ca Stomach
• Cogenital hypertrophic pyloric stenosis
• Sub-Acute Perforation of a Peptic Ulcer

40. Stomach and Duodenum
Ca Stomach
1. There is irregular firm lump which moves
on respiration
2. Patient is usually elderly and has
anorexia and weight loss
3. Barium meal would show filling defect
4.Upper GI Endoscopy

41. Stomach and Duodenum
Sub-Acute Perforation of a Peptic Ulcer
1. Localized, tender, inflammatory mass
may be present with a central abscess
2. History of peptic ulcer
3. Barium meal would reveal the ulcer

42. Hepatic Flexure of Colon

43. Hepatic Flexure of Colon
Carcinoma of Colon
• 1. This commonly occurs in men above the
age 40 years
2. Change in bowel habits, melena
3. The lump is irregular, firm and moves
poorly on respiration
4. Occult blood may be present in stools
5. Colonoscopy

44. Hepatic Flexure of Colon
Intussusception
• 1. There is sudden intermittent abdominal
pain with vomiting.
2.Passage of blood and mucus (red currant
jelly) per anum without fecal odour.
3. There may be curved, sausage shaped
lump
4. Barium enema would show typical pincer
shaped ending of the radio-opaque material.

45. Kidney swelling

46. Kidney swelling
• Ballotable
• Slight movement with respiration
• Renal angle is full
• Percussion- resonant

47. Kidney swellings
• Hydronephrosis/Pyonephrosis
• Carcinoma
• Nephroblastoma –Wilm’s tumour

48. Suprarenal swelling

49. Suprarenal swelling
• Like kidney swelling
• From cortex or medulla

50. From adrenal cortex
•

51. From adrenal cortex
• Hyperplasia
• Benign adenoma
• Carcinoma

52. From adrenal medula
• Pheochromocytoma
• Neuroma
• Neuroblastoma

53. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

54. Get this ppt in mobile

55. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
=0
• https://www.facebook.com/doctorpradeeppa
nde/?ref=pages_you_manage