September 24, 2015 - Acute Abdomen II Flashcards Preview

COURSE 1 > September 24, 2015 - Acute Abdomen II > Flashcards

Flashcards in September 24, 2015 - Acute Abdomen II Deck (15):
1

Signs and Symptoms of Acute Abdomen

Abdominal pain

Distension

Nausea / vomitting

Constipation / obstipation

2

Obstipation

Severe or complete constipation caused by obstruction.

3

Proximal SBO Symptoms

Proximal small bowel obstruction

- Vomitting is early and profuse

- Rapid dehydration

- Distension is minimal and not many fluid levels on imaging.

4

Distal SBO Symptoms

Distal small bowel obstruction

- Vomitting is often delayed

- Pain and central distension

- Multiple air/fluid levels on imaging

5

LBO Symptoms

Large bowel obstruction

- Distension is early and pronounced

- Pain is less severe

- Vomitting and dehydration occur later

6

Pathophysiology of Bowel Obstruction

Distension causes decreased absorption, and then increased secretion.

Increased intraluminal pressure.

Compresison of venules, bowel wall edema, decreased inflow from capillaries, and ischemia.

7

Types of Mechanical Obstruction

1. Intraluminal

2. Intrinsic bowel lesions

3. Lesions extrinsic to the bowel

8

Intraluminal Causes of Obstruction

1. Intussusception (the inversion of one portion of the intestine within another)

2. Gallstone ileus (gallstone gets lodged in the small intestine)

3. Bezoars

9

Intrinsic Bowel Lesions of Obstruction

1. Congenital

2. Neoplastic

3. Inflammatory

10

Extrinsic Causes of Obstruction

1. Adhesions (scar tissue)

2. Hernias

3. Volvulas (twisting of stomach or intestine)

4. Neoplasms

5. Abscess

11

Management for Complete Obstruction

Early surgery. Usually 12-24 hours be in surgery because of the high risk of strangulation (20-40%).

12

Management for Partial Obstruction

Much lower risk of strangulation, and many will resolve without operative intervention. These can wait and follow with observation.

13

Absolute Indication for Surgery

Peritonitis

Free air

Irreducible hernia

14

Mesenteric Thrombosis

Progressive development of severe central abdominal pain.

15

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