Flashcards in Acute Abdomen Emergencies Deck (167)
Extra-abdominal systems that can cause abdominal pain
Cardiac, thoracic, metabolic, hematologic, infections or others
What are life threatening causes of abdominal paint that can't be missed?
Abdominal aortic aneurysm and dissection
Acute bowel obstruction
#1 cause of abdominal pain in ER
Red flags in the history of acute abdominal pain
Recent GI instrumentation
Red flags in the pain characteristics of acute abdominal pain
Significant pain at onset
Pain followed by emesis
Constant pain for <2 days
Red flags on PE for acute abdominal pain
Signs of shock (hypotension and tachycardia)
What cause of abdominal pain radiates to right subscapular area?
What cause of abdominal pain radiates to shoulders
Perforated duodenal ulcer
What cause of abdominal pain radiates to testicles?
What cause of abdominal pain radiates to epigastric area, jaw, neck or UE?
What cause of abdominal pain radiates to low back?
How does visceral abdominal pain present?
Dull, aching and colicky
Distention, ischemia, inflammation or spasm of a hollow organ
How does parietal abdominal pain present?
Peritoneal irritation, ischemia, inflammation, stretching of parietal peritoneum
What are aggravating and alleviating factors to always ask about with abdominal pain?
What patient is restless and can't sit still?
What patient is lying perfectly still and supine?
Common causes of hypoactive or absent bowel sounds
Peritonitis or small bowel obstruction
Common causes of hyperactive bowel sounds
Blood or inflammation in the GI tract
What must be done with men and women that present with lower quadrant/hypogastric pain?
Initial diagnostics for abdominal pain
CBC with diff
AST, ALT, alk phos, total bilirubin
Urine pregnancy test
What is lactic acid a marker of?
What do you use plain films for?
Dilated bowel loops, air fluid levels, free air, constipation or foreign body
What is a CT without contrast used for?
Renal stone or obstruction
What is a CT with IV contrast used for?
Ischemic bowel, diverticulitis, peritonitis or AAA
What is a CT with oral contrast used for?
Really skinny adults or kids
When is an u/s used?
Gall bladder, free fluid, renal, ovarian or testicular
General management for abdominal pain
Abx if indicated
Consults, monitor for sepsis and shock, repeat exa, and vitals
Reasons for urgent surgical referral
Rapid sx evolution (increasing TTP/rigidity, pain is severe)
Who may have atypical presentations related to abdominal pain?