Acute Abdomen Flashcards
What is acute abdomen?
An acute abdomen refers to a rapid onset of sudden, severe abdominal pain. It is in many cases a medical emergency, requiring urgent and specific diagnosis. Several causes need surgical treatment.
Abdominal pain is usually a feature but a pain-free (and more atypical) abdomen can also occur, in which people particularly?
- Elderly
- Children
- Immunocompromised
- In 3rd trimester of pregnancy
Give a differential diagnosis for upper abdominal pain – remember there are medical causes
- Hepatitis or Hepatic congestion/abscesses
- Adhesions
- Strangulated hernia
- Cholecystitis
- Gastric ulcer
- Appendictis
- Ectopic pregnancy
- PID
- Acute pancreatitis
- Acute divericulitis
- Ulcerative colitis
- Crohn’s disease
- GI malignancy
- Gastroenteritis
- Endometriosis
- Myocarditis or ischaemia
- Testicular torsion
- Kidney stones
- (Lower lobar) Pneumonia
What is meant by colicky pain?
This is a squeezing pain that builds up and then eases off and usually comes in waves. Indicates a blockage in a duct or hollow organ and represents body’s attempt to overcome the blockade.
What causes the following type of pain?
- retrosternal + burning
- made worse by citrus fruits, spicy foods
- eased by antacids an milk
- occasionally relieved by GTN
Oeseophagitis
What most likely causes the following type of pain?
- epigastric, often localised
- burning/gnawing
- can lead to peritonitis due to perforation
peptic ulcer pain
What can cause abdominal pain that radiates to the back under the scapula?
- Gallstones / biliary colic
- Experienced in epigastium/RUQ
- Sudden + builds up
- Severe and causes patient to roll around in agony
- Although pain is labelled as colic, it rarely fluctuates
Describe pain caused by pancreatitis?
- acute: severe pain in epigastrium
- often radiates to back
- in chronic pancreatitis, less intense
How do renal stones/colics present?
- pain felt in loins
- severe
- patient rolls around in agony
- pain radiates down abdomen + can be felt in testes/labia
How does pain from IBS present?
- dull, sharp or burning
- affect any part of abdomen
- the pain however is rarely severe
What are some associated symptoms for abdominal pain?
- Nausea, vomitting, burping
- Anorexia
- Fever
- Jaundice
- Weight loss
- Urinary frequency, haematuria
- Flatulence, diarrhoea, constipation, blood?
- Heartburn
What are some risk factors associated with abdominal pathology?
- Smoking
- Alcohol
- Increasing age
- H Pylori infection
- Drugs: NSAIDs, steroids
- Diet: High cholesterol, low fibre
- Viral infections
- Dehydration
- Immobility
- Hypercalcaemia
- Anxiety + depression
What are the 5 common causes of abdominal distension?
- Fat - obesity
- Fetus - pregnancy
- Flatus - paralytic ileus/obstruction
- Fluid - ascites
- Faeces - constipation
What can you ask about in terms of diarrhoea?
- consistency - how formed is it?
- mucous - IBD/IBS
- blood - melaena? fresh blood?
- urgency - IBD/IBS/gastroenteritis
- recent abx? - C. Diff
- recent suspect food? - food poisoning
- laxative use?
What is steatorrhoea and what does it indicate?
- Pale stool
- biliary obstruction
- gallstones / malignancy
