A distended abdomen occurs when the abdomen is swollen beyond its normal size. Distension can be generalized across the entire abdomen or localized to certain areas. Organic causes of a distended abdomen include pregnancy, bowel obstructions, gastrointestinal diseases, liver disease, organ enlargement, and internal bleeding. Functional causes include gas, constipation, urinary retention, and disorders of muscle contractions involved in digestion. Surgical causes of small and large bowel obstruction include adhesions, hernias, volvulus, tumors, trauma, abscesses, and various congenital abnormalities.

1. DIFFERENTIAL DIAGNOSIS
OF DISTENDED ABDOMEN
BHAVADHARANI AS
4TH BHMS 21

2. ABDOMINAL SWELLING
 A distended abdomen is measurable swollen
beyond its normal size. Its often
accompanied by the feeling of being bloated
with trapped gas or digestive contents
 Distension may occur as a
Generalized
Localized
Localized that becomes generalized

3. CAUSES
ORGANICCAUSES :
Pregnancy
Menstruation which causes water retention
Significant recent weight gain which stored
as intra abdominal fat and restrict digestion.
An obstruction of the small or large bowel
causing a build up of digestive contents.

4. Certain GI diseases cause gas and bloating ,
including small intestinal bacterial
overgrowth , celiac disease, exocrine
pancreatic insufficiency and inflammatory
bowel disease.
Inflammation of the abdominal lining
(peritonitis)
Build up fluid in abdomen caused by liver
disease (ascites).
Organ enlargement from inflammation or a
growth

5. Partial paralysis of the stomach
(gastroparesis) causing a build up of
digestive contents .
Internal bleeding (intra abdominal
hemorrhage).

6.  FUNCTIONALCAUSES :
Gas from functional indigestion , food
intolerance or irritable bowel syndrome
Constipation causing a build up of feces &
back up of digestive contents
Urinary retention causing a build up of urine
like urethral stricture.
A disorder of the muscle contractions
involved in digestion ( intestinal pseudo –
obstruction), causing digestive contents to
back up

7.  Abdominal muscle weakness which
causes the abdominal contents to sad
outwards and downwards ( enteroptosis).

8. 5 f’s of distension of
abdomen
 Fat – obesity / alcohol consumption
 Faetus – pregnancy
 Fluid – ascites
 Faeces – constipation
 Flatus – obstruction & pseudo obstruction

10. SURGICAL CAUSES OF SMALL AND
LARGE BOWL OBSTRUCTION
SMALL BOWEL
1. Adhesions
2. Hernias
3. Extrinsic
Congenital
Malrotation with ladd’s band
or midgut volvulus
Annular pancreas
Superior mesentrica
syndrome
4.Inflammatory
endometriosis
LARGE BOWEL
1.Adhesions
2. Hernias
3. Volvulus
4.Endometriosis

11. 5. Neoplastic
Carcinomatosis or tumor encasement
from non small bowel source
6. Traumatic
7. Intra abdominal abscess
8. Hematoma
9. Mural
Congenital
Small bowel atresia
Stenosis
Diaphramatic webs
Imperforated anus

12. Small bowel duplication or
mesentric cysts
Other remenents of
omphalomesentric duct