Acute Abdomen

Question 1

How does it present?

Answer 1

Abdo pain 
-Visceral, parietal, extra-abdominal 
Associated symptoms: 
-Nausea/vomiting
-Burping 
-Heartburn
-Change in bowel habit 
-PR blood/mucus

Question 2

Associated symptoms of acute abdomen + main compliant?

Answer 2

-Abdo pain 
\+ 
-Nausea/vomiting 
-Burping 
-heartburn 
-Change in bowel habit
-PR blood/mucous

Question 3

How is an acute abdomen diagnosed?

Answer 3

Important location of pain 
Colour of vomit/blood and whether it is projectile 
Bowel sounds are absent in ileum 
FBC 
Erect CXR (1st line)
AXR (obstruction/perforation)
CT (Gold standard)
US (If RUQ and RIF pain)

Question 4

When else are bowel sounds in ileum absent?

Answer 4

Acute abdomen
BUT
Also the very obese

Question 5

How is an acute abdomen managed?

Answer 5

• Often do nothing and observe
• Immediate surgery if faecal peritonitis or ischaemic gut
• When giving analgesia check allergies & give morphine/paracetamol IV + anti-emetic
• Munchausen and drug addicts will come in for pain relief