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GI/GU Illness > Acute Abdomen: Obstruction, Perforation, Inflammation > Flashcards

Acute Abdomen: Obstruction, Perforation, Inflammation Flashcards

1
Q

What happens when perforation occurs in the acute abdomen?

A

direct communication of organ with peritoneum

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2
Q

What happens when here is peroration of the stomach/small intestine/large bowel? (3)

A
  1. rapid bacterial and chemical spread
  2. peritonitis
  3. septicaemia
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3
Q

What are the clinical signs of perforation? (3)

A
  1. severe pain
  2. lies still in bed
  3. rigid board like abdomen
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4
Q

What is seen on x-ray in a perforation?

A

air under the diaphragm

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5
Q

How can peritonitis be treated? (2)

A
  1. control of infection

2. sealing/removal of perforation

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6
Q

What are the consequence of bowel obstruction?

A
  1. ischaemia
  2. necrosis
  3. perforation
  4. inflammation
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7
Q

What is the presentation of intestinal obstruction? (3)

A
  1. abdominal pain and disension
  2. constipation/obstipation
  3. vomiting
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8
Q

What are the common causes of intestinal obstruction? (4)

A
  1. hernia
  2. adhesion
  3. intussusception
  4. Volvulus
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9
Q

Where do hernias usually occur? (4)

A
  1. inguinal
  2. femoral
  3. para umbilical
  4. surgical scars
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10
Q

What are the complications of hernias?

A
  1. bacterial invasion
  2. transmural infarction
  3. visceral peritoneal inflammation
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11
Q

What causes intussusception?

A
  1. reactive lymphoid hyperplasia in paediatrics

2. tumours in adults

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12
Q

What is stool like with an intussusception?

A
  1. red current jelly stool
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13
Q

How is intussusception treated?

A

enema

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14
Q

What is a volvulus?

A

twisting of any mesentrized viscous around its mesenteric root

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15
Q

What are the watershed areas of the intestine?

A
  1. splenic flexure

2. sigmoid colon to rectum

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16
Q

What are the characteristics of acute intestinal ischaemia? (5)

A
  1. sudden onset left lower abdominal pain
  2. urge to defacate
  3. +/- blood
  4. elevated LDH
  5. greater mortality if right sided
17
Q

What are the characteristics of chronic intestinal ischaemia?

A
  1. mesenteric angina

2. post-prandial pain

18
Q

What is the pathology of acute intestinal ischaemia? (4)

A
  1. usually complete occlusion
  2. transmural
  3. coagulative necrosis
  4. gangrene
19
Q

What is the pathology of chronic intestinal ischaemia?

A
  1. progressive stenosis
  2. often mucosal
  3. ulceration, surface inflamation
  4. mural - fibrosis and stricture
20
Q

What are the complications of appendicitis? (7)

A
  1. perforation
  2. fistula
  3. abscess
  4. empyema
  5. intussusception
  6. pyophlebitis
  7. liver abscess
21
Q

What mimics appendicitis? (4)

A
  1. mesenteric lmphadenitis
  2. merkel’s diverticulitis
  3. salpingitis
  4. ectopic pregnancy
22
Q

What is the typical clinical presentation of acute appenticitis? (4)

A
  1. nausea/vomitting
  2. low grade fever
  3. periumbilical pain moving to the right iliac fossa
  4. mild/moderate tenderness on examination at McBurney’s point
23
Q

What is the aetiology of acute appendicitis? (5)

A
  1. inflammation secondary to obstruction
  2. worms
  3. faecolith
  4. foreign bodies
  5. lymphoid hyperplasia
24
Q

What is the pathogenesis of appendicitis? (6)

A
  1. arterial pressure > tissue pressure > venous pressure
  2. venous engorgement, stasis, venous infarction
  3. blockage increased lumen pressure
  4. bacterial invasion
    transmural infarction
  5. visceral peritoneal inflammation
  6. obstruction
25
Q

What is diverticular disease?

A

normal mucosa in abnormal place

26
Q

What is the pathogenesis of diverticular disease? (2)

A
  1. weakness at the site of perforating arteries

2. intraluminal pressure

27
Q

What is the clinical presentation of diverticular disease? (5)

A
  1. most asymptomatic
  2. lower abdominal discomfort/pain
  3. variation in bowel habit
  4. blood
  5. +/ mass/tenerness
28
Q

What are the complications of diverticular disease? (5)

A
  1. obstruction
  2. diverticulitis
  3. diverticular abscess
  4. rupture and peritonitis
  5. haemorrhage

GI/GU Illness (15 decks)

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