What are life threatening causes of acute abdominal pain?
- Ischaemic bowel
- Medical causes (DKA, Pneumonia, MI, Addisonian crisis)
How would you explore acute abdominal pain?
What would you want to ask about on systemic enquiry in someone with acute abdominal pain?
- How patient feels
- Gastro - nausea, vomiting, bowel habit, blood/malaena, weight loss
- Urological - dysuria, urinary frequency
- Gynae - LMP, PV discharge, contraception, chance of pregnancy
What would you as about on PMH in someone with acute abdominal pain?
- Happened before
- Other medical conditions
- Previous surgery - particularly abdominal
What would you want to ask about on social history?
What would you look for on examinaion in someone with acute abdominal pain?
- Inspect - movement with resps, grey turners/cullen's sign, scars
- Guarding/rebound tenderness
- Murphy's/Rovsig's sign
- Percussion tenderness
- Bowel sounds
- External genetalia/PR if indicated
What bloods would you want to do in someone with acute abdominal pain?
- Cap glucose
What bedside tests would you consider doing in someone with acute abdominal pain?
- Urine dipstick
- Urine BHCG
What imaging sould you consider doing in someone with acute abdominal pain?
- Erect CXR
- Fast Scan
- USS/CT abdo/pelvis
What structured approach would you take to determining what investigations you are going to do in someone with acute abdominal pain?
- Specific tests
What are surgical causes of acute abdominal pain?
- Ruptured AAA
- Gallstone disease
- Acute pancreatitis
- Renal colic
- Bowel obstruction
- Acute mesenteric ischaemia
- Testicular torsion
- Ischaemic colitis
- Strangulated hernia
- Meckels diverticulum
- Mesenteric adenitis
- Hepatic abscess
- Psoas abscess
What are medical causes of acute abdominal pain?
- Peptic ulcer
- Crohn's Disease/UC
- SC crisis
- Budd-chiari syndrome
- Addisonian crisis
- Acute intermittent porphyria
What are gynaecological causes of Acute abdominal pain?
- Ectopic pregnancy
- Ovarian Torsion
- Acute salpingitis/PID
- Ovarian cyst rupture
- Fitz-hugh-curtis syndrome