Acute abdomen and appendix Flashcards
acute abdomen approach
A 21 years old single lady presents to the ER with severe lower abdominal pain for 1 day.
She was agitated
Pulse rate 140/ min
BP 90/50
Afebrile
with tender lower abdomen.
What is your next step?
A. Check B-HCG
B. Resuscitate with crystalloids
C. Resuscitate with blood products
D. Go for laparoscopic exploration
B. Resuscitate with crystalloids
always start with ABC
acute abdomen approach
A 21 years old single lady presents to the ER with severe lower abdominal pain for 1 day.
She was agitated
Pulse rate 140/ min
BP 90/50
Afebrile
with tender lower abdomen
WBC 12,000
Hgb 8 d/dl . she was stabilized with IV fluids
What is your next step?
A. Check B-HCG
B. Resuscitate with crystalloids
C. Resuscitate with blood products
D. Go for laparoscopic exploration
A. Check B-HCG
even if shes single you need to rule out ectopic pregnancy
Recall
Young single female patient checklist prior to do CT
A. Previous CT
B. Full bladder
C.Volume status
D. B-hCG
D. B-hCG
Appendix
a 15 years old girl is presented to ER with** 5 days hx of RLQ pain and fever of 39C**
WBC 18,000
Ultrasound confirmed a 6cm abscess around an inflamed appendix.
What is the appropriate treatment for this patient?
A. Laparotomy, drainage of abscess and appednectomy
B. Precutaneous drainage, antibiotics and elective appendectomy in 6-8 weeks
C. Precutaneous drainage, antibiotics and colonscopy in 6-8 weeks
D. Conservative treatment with IV antibiotics then colonoscopy
B. Precutaneous drainage, antibiotics and elective appendectomy in 6-8 weeks
6cm is large the cutoff point is 4cm so it needs drainage
why elective?
to avoid recurrent appendicits in the future
Appendix
A 23 years old man presents to the ER suspected appendicitis.
He is taken for laparoscopic exploration and found to have a normal-looking appendix.
What is the next step?
A. Perform appendectomy
B. close and follow with colonscopy
C. Close
D. Examine small bowel
D. Examine small bowel
look for other pathologies
meckels diverticulum
