Acute Abdomen Flashcards
define acute abdomen
combination of symptoms and signs including abdominal pain which result in a patient being referred for urgent general surgical pinion
give a brief description of the peritoneum
> 2 layers
semi-permeable membrane
specialised lymphatics
fibrinolytic activity creates frictionless surface
describe the routes of infection that may lead to peritonitis
> perforation of GI tract/biliary tract
female genital tract
penetration of abdominal wall
haematogenous spread
what sort of peritonitis occurs from failure of localisation?
generalised peritonitis
why may the peritoneum fail to localise and infection?
> contamination may be too rapid
contamination may be persistent
abscess may rupture
what does the aetiology of obstruction depend on?
> age of the patient
> environment
what are the cardinal features of intestinal obstruction?
> pain > vomiting > distension > constipation > borborygmi
what do features of intestinal obstruction depend on?
the site of the obstruction, whether it is distal or proximal
what symptoms would obstruction in the duodenum cause?
vomiting but no other symptoms (patient would die before the noticed a change in he bowel habit)
describe the features of a distal obstruction of the intestine
there would be early noticing of bowel change, no faeces would be passed, then no wind then there would be bloating and pain.
where are receptors for somatic pain located?
in the parietal peritoneum/abdominal wall
with what do afferent signals from somatic pain pass?
with segmental nerves
what is the effect of peritonitis and obstruction?
there is fluid loss and baceraemia (and endotoxaemia). this leads to circulatory collapse and breakdown of mucosal layer that will eventually lead to death.
what is the general management for acute abdomen?
> assess
investigate
observe
treat
what ward tests would you carry out for acute abdomen?
urine
