Acute Abdomen SA Flashcards Preview

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Flashcards in Acute Abdomen SA Deck (20):
1

Define acute abdomen

Condition of severe abdomenal pain caused by acute disease or injury to internal organs

2

What are the 3 stages to treating acute abdomen?

- Identify problem
> Diagnostic plan
> Treatment plan
> Follow up plan

3

What 4 physiological problems may cause pain in the abdo?

- Distension
- Inflammation
- Ischaemia
- Traction

4

How may physiological disturbances be remembered?

Vitamin D
V - cascular (thrombosis/heamorrhage)
I - Infection/inflammation/immune mediated
T - toxin/trauma
A - Anomalous
M - Metabolic
I - Iatrogenic/idiopathic
N - Neoplasia/nutrition
D - Degenerative

5

Give DDx for stomach/intestine related pain

- GDV
- Mesenteric torsion
- Infarction
- Ulceration
- GIT infection (parva, HGE)
- FB
- Intussescpetion
- Toxin
- Neoplasia

6

Give DDx for pancreatic related pain

Pancreatitis, abscess, neoplasia

7

Give DDx for liver related pain

Torsion
Cholangiohepatitis
Abscess
Bile obstruction

8

Give DDx for spleen related pain

- Torsion
- Infarction
- Haematoma
- Abscess
- neoplasia

9

Give DDx for peritoneal and retroperitoneal cavity related pain

Peritoneal: septic peritonitis (GIT, repro, external) Uroperitoneum, bile peritonitis [rare] severe distension from transudate/haemabdomen, abdo wall trauma
Retroperitoneal: renal infarctino, pyelonephritis due to UTI, neoplasia

10

Give DDx for bladder related pain

Cystitis, calculi, urethral obstruction

11

Give DDx for repro related pain

Pyometra, dystocia, prostatic abscess, prostatitis

12

What pay be confused for abdominal pain?

- Spinal pain
- Nervousness -> flinching
- Respiratory problems (compression of abdo -> compression of thorax)
- Hyperaesthesia (eg. cannabis consumption)

13

What diagnostic tests are usually carried out for acute abdomen?

- History/PE
- PCV/TS/blood smear---> CHEAP, QUICK, EASY
- Blood glucose -----------------^
- Abdo ultrasound for free fluid
- Abdomenocentesis (U/S or blind)
- Diagnostic peritoneal lavage
- Abdo radiographs (VD, R lateral for GDV, L lateral for pylorus, check fluid/obstruction/free gas, contrast studies)
- CT, heam/biochem
- Ex lap

14

What CV problem is commonly seen in dogs with GVD?

Ventricular premature complexes and tachycardia

15

What pathology may lead to hypoglycaemia?

Septic peritonitis

16

Which diagnoses are classified as surgical emergencies?

- Gastric dilation ± volvulus (GVD)
- Septic peritonitis (GIT/uterine rupture/prostatic abscess rupture)

17

Which diagnoses may emergency surgery be considered?

- Risk of septic peritonitis
> Partial/complete obstruction
> Intussusception
> Penetrating abdo wound
> Abdo bite/crush injury

18

What diagnoses may be classed as procedural or surgical emergencies?

- Metabolic emergency (uroperitoneum [drain peritoneum -> v azotaemia], urethral obstruction, bile peritonitis)
- Vascular emergency (splenic torsion, strangulated hernia, mesenteric torsion, intractable haemorrhage (replacing entire blood volume)

19

When should nutritional supplements/feeding assistance be provided?

Anorexia >3d

20

Give 4 anagesia options for dealing with acute abdomen. Which is generally contraindicated?

1. Pure opioids (methadone, morphine, fentanyl)
2 .Partial agonist opioid (buprenorphine)
3. NSAIDs (meloxicam, carprofen) *CARE* Renal and GIT toxicity esp if poorly perfused
4. Multimodal (ketamine CRI, lidocaine CRI)