Acute abdomen Flashcards Preview

GI > Acute abdomen > Flashcards

Flashcards in Acute abdomen Deck (20)
Loading flashcards...
1
Q

what clinical syndromes usually require laparotomy?

A

rupture of an organ

peritonitis

2
Q

What are the causes of infected peritonitis?

A
  1. perforation of GI tract or reproductive system
  2. Disruption of peritoneum by surgery or trauma
  3. SBP
  4. Systemic infections e.g. tb
3
Q

What are the causes of non-infective peritonitis?

A
  1. leakage of sterile bodily fluids into peritoneum - these become infected once in the peritoneal cavity
  2. Autoimmune disease e.g. lupus
4
Q

What are the symptoms of peritonitis?

A

Sudden onset acute abdominal pain
Tenderness (+/- rebound/percussion pain)
Fever

5
Q

What are the signs of peritonitis?

A
Prostration  - lying stretched out on the ground
Lying still 
Washboard rigidity
\+ve cough test  
Guarding 
Shock
HR >100
6
Q

What investigations should you carry out in peritonitis and why?

A

Erect CXR - look for air under diaphragm
Serum amylase - acute pancreatitis causes similar presentation
US/CT to confirm diagnosis

7
Q

What are the causes of local peritonitis?

A

diverticulitis
cholecystitis
salpingitis
appendicitis

8
Q

What is the management of peritonitis?

A
  1. IV fluids and electrolytes
  2. IV abx
  3. Laparotomy
9
Q

What is the management of abscess formation in local peritonitis?

A

Drainage - either percutaneous or laparotomy

10
Q

What is colic?What causes it?

A

regularly waxing and waning pain caused by muscular spasm in a hollow viscus

11
Q

How does colic differ to peritonitis?

A

colic causes restlessness and the pt may be pacing around whereas in peritonitis the pt is completely still and rigid

12
Q

Why shouldn’t a patient be rushed to theatre if they have an acute abdomen?

A

anaesthesia compounds shock, resuscitate properly first unless blood is being lost faster than it is being replaced

13
Q

What is aLWAYS important to exclude in acute abdomens?

A

PREGNANCY

14
Q

What are unsuspected easily undetectable causes of acute abdomen that are important to consider?

A

mesenteric ischaemia
acute pancreatitis
leaking AAA

15
Q

What are causes of RUQ abdominal pain?

A
acute cholecystitis
duodenal ulcer
hepatitis
congestive hepatomegaly
pyelonephritis
appendicitis
R sided pneumonia
16
Q

What are the causes of LUQ pain?

A
ruptured spleen
gastric ulcer
aortic aneurysm 
perforated colon
pyelonephritis
L sided pneumonia
17
Q

What are causes of RLQ pain

A
appendicitis
salpingitis
ruptured ectopic
renal/ureteric stone 
strangulated hernia
mesenteric adenitis
meckels diverticulum
crohns
perforated caecum
psoas abscess 
tubo-ovarian abscess
18
Q

What are causes of LLQ

A
Sigmoid diverticulitis
Salpingitis
tubo-ovarian abscess
ruptured abscess
strangulated hernia
perforated colon
crohns
UC
renal/ureteric stones
19
Q

What are the causes of epigastric pain

A
pancreatitis
MI
peptic ulcer
acute cholecystitis
perforated oesophagus
20
Q

What are causes of umbilical pain

A
intestinal obstruction
acute pancreatitis
early appendicitis
mesenteric thrombosis
aortic aneurysm 
diverticulitis