| Afferent loop syndrome |
Occurs after Billroth II procedure. The duodenum and jejunum proximal to the gastrojejunostomy become chronically obstructed. The symptoms are usaually very vague. CT is probably the most sensitive form of imaging.
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| Allen's test |
The is a test of the colaterral circulation in the hand. The patient is asked to squeeze the hand into a fist, thereby draining the hand of blood. The radial and ulnar arteries are both compressed in the wrist and one released. The palm flushes pink confirming arterial flow in the released artery. This is then repeated on the other side. The main use is pre-CABG where a radial artery harvest is anticipated. |
| Battle's sign |
Ecchymosses behind the ear over the mastiod (thanks to Rajat Thakur for the correction) cf Panda eyes Periorbital ecchymoses, occuring in base of skull fractures. |
| Beck's triad |
The triad of cardiac tamponade. Hypotension, juggluar venous distension , muffled heart sounds. |
| Boerhaave's syndrome |
Spontaneous oesophageal rupture, often wrongly described as traumatic rupture. |
| Charcot's triad |
The classic three signs seen in ascending cholangitis. Right upper quadrant pain, fever with rigors in the presence of jaundice. Actually only seen in about a quarter of patients. See also Reynolds' pentad
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| Chvostek's sign |
Elicited in hypocalcaemia. The facial muscles twitch when the examiner taps on the facial nerve. Look particularly at the corner of the mouth. See also Trousseau's sign |
| Courvoisier's law |
"If, in the presence of jaundice, a mass is present in the right upper quadrant, the jaundice is unlikely to be due to stones." So the alternative causes of head of pancreas carcinoma is more likely. |
| Cullen's sign |
Bruising around the umbilicus secondary to retroperitoneal bleeding. E.g. ruptured AAA or haemorrhagic pancreatitis. See also Grey Turners Sign |
| Cushing's triad |
A sign of increased intra-cranialpressure. *** CHECK Hypertension*** with bradycardia and irregular respiration |
| Dumping syndrome |
This is really "Gastric Dumping Syndrome" and refers to the rapid emptying of the stomach into the jejunum. It is split into early and late. Early dumping occurs whilst a patient is eating or just after, whereas late dumping occurs a few hours afterwards. The rapid dumping of undigested food causes excessive stimulation of the pancreas and insulin production often resulting in hypoglycaemic episodes.
Common causes are post gastric surgery such as gastrectomy, but it occasionally occurs after cholecystectomy.
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| Fox's sign |
Just like Cullen's and Grey Turner's this is a sign of retroperitoneal bleeding. It was George Fox that described the infra-inguinal brusing. |
| Grey Turner's sign |
Brusing in the flanks is seen from bleeding in the retro-peritoneum. Usually associated with acute pancreatitis. Grey Turner himself was an English surgeon born in 1877, gaining his fellowship to the RCSEng in 1903. |
| Hamman's sign |
A rarely found sign of oesophageal perforation (see also Boerhaave's). A crunching heart sound on auscultation of the chest. It is heard in synchrony with heart sounds as opposed to respiration. Actually, represents mediastinal air. |
| Homan's sign |
This is an indicator of deep vein thrombosis. It is named after an American physician called Thomas Homan. He described passive dorsiflexion of the foot causing pain in the calf in patient that had DVTs. The test has fallen out of favour however, due to the small risk of dis-lodging the thombosis! |
| Kehr's sign |
Kehr's sign is an example of refered pain. Irritation of the diaphragm by intra-peritoneal pathology (e.g. blood) causes acute pain in the shoulder tip. Classically, a positive left Kehr's sign is caused by a ruptured spleen. |
| Leriche's syndrome |
Seen in iliac occlusive disease. - Buttock claudication - Buttock atrophy - Impotence |
| May-Thurner syndrome |
A DVT of the left ilio-femoral vein caused by compression of the overlying RIGHT iliac artery or aortic bification. Doesn't happen on the right as the vein takes a more direct course back to the IVC. |
| McBurney's point |
McBurney's point refers to the location of the base of the appendix. It lies one third of the way along an imaginary line drawn from the anterior superior iliac spine to the umbilicus. An important landmark when performing an open appendicectomy.
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| McBurney's sign |
The sign refers to tenderness at McBurney's point being an indicator of appendicitis. |
| Milroy's disease |
Primary familial lymphoedema. Autosomally inherited.
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| Mirizzi's syndrome |
Refers to obstructive jaundice caused by a stone impacting on Hartman's Pouch. It is graded I - IV. One being no fistula and then increasing degrees of fistula formation graded by comparison to CBD size.
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| Murphy's sign |
A positive finding in acute cholecystitis. Palpation under the right costal margin whilst asking the patient to breathe in causes pain as the inflammed gallbaldder connects with the palpating hand. |
| Ogilvie's syndrome |
Colonic pseudo-obstruction. |
| Peutz-Jegher's syndrome |
This is characterised by multiple hamartogenous polyps of the gastrointestinal tract and muco-cutaneous pigmentation primarilty of the lips, genitals, feet and hands. It is an autosomal dominant condition and these patients have a increased risk of developing cancer of the lung, ovary, pancreas and breast. |
| Plummer-Vinson syndrome |
Also known as Paterson-Brown-Kelly syndrome. It is associated with long term iron deficiency anaemia. Oesophageal webs form causing dysphagia. |
| Reynolds' Pentad |
The three findings of Charcot's triad for ascending cholangitis plus septic shock and confusion. Indicative of very serious cholangitis. |
| Rovsing's sign |
This is a sign of appendicitis. Palpation in the left lower quadrant results in pain in the right lower quadrant. |
| Scarpa's fascia |
This is the deep layer of superficial membranous or lamellar abdominal fascia around edge of the superficial inguinal ring. |
| Sister Mary Joseph's nodule |
This is a metastatic lesion in the umbilicus from an intra-peritoneal malignancy. Sometimes mis-quoted as a lymph node. Classically described as being from a gastric or ovarian malignancy but can also be from colonic or pancreatic cancer |
| Saint's Triad |
The triad of diverticular disease, gallstones and hiatus hernia appearing together and is known as Saint's triad. Remembered by the mnemonic DGH as in the common things you will see in a District General Hospital |
| Stemmer sign |
A sign found in lymphoedema. The clinician can not pinch a fold of skin on the dorsum of the second toe and is due the skin becoming inelastic. |
| Tietze's syndrome |
Tietze's syndrome is the eponym for costochondritis. An inflammation of the cartilage between the ribs and the sternum. It should be considered in the differential diagnosis for chest pain. |
| Trousseau's sign |
Carpopedal spasm occurring with blood flow occlusion in hypocalcaemia. See also Chvostek's sign |
| Virchow's node |
A left supraclavicular node from metastatic tumour. Usually gastric. Apparently, Virchow found one on himself. |
| Virchow's triad |
Virchow' triad is a tribute to one Rudolf Virchow. He carried out some work that eludued to pulmonary emboli being caused by thrombosis in the veins of extremeties and list a multitude of factors that cause thrombosis but never actually named a triad.
Regardless the triad attributed to him of:
- Changes in the constituents of blood
- Changes in the vessel wall
- Changes in the flow of blood
as contributors to the formation of thrombosis acts as a useful aide memoir.
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