Flashcards in The acute abdomen Deck (32)
What is an acute abdomen
Abdominal pain which has been around for less than 10 days
Causing severe morbidity or threat to life
Who does it present to?
What are some of the common causes of acute abdomen
Non-specific abdominal Pain (1/3rd of patients)
Diverticular disease of the colon
Bacterial and viral infections
What are the ages for women of child-bearing age?
What are some of the less common causes of acute abdomen
Ruptured or symptomatic AAA
What is Munchhausen's syndrome
Attention - making something up
What are drug seekers?
Typically women who want morphine who are manipulating
3 types of abdominal pain
5 associated symptoms of abdominal pain
Heartburn / indigestion
Change in bowel habit
PR blood / mucus
In what condition will the pain totally disappear?
What are the 9 regions of the abdomen
Right and Left Hypochondrian
Right and Left Lumbar
Right and Left iliac fossa
What questions do you ask about vomit?
Green or foodstuff
What is golden yellow vomit
What colour is digested bile
What is localised peritonism
Localised pain and guarding
What is peritonitis
Refers to pain in all 4 quadrants
What does generalised peritonitis
Usually perforated duodenal ulcer
Describe the bowel sounds in ileus
What is the common analgesia given?
IV morphine with anti-emetic
What is Cullen's sign
Periumbilical bruising often with Pancreatitis
What are initial investigations for abdomen?
Bloods: FBC,LFT,UE, CRP, Ca, Lactate, Coag
AXR and erect if possible CXR
Or straight to CT
Why is amylase so important to do?
What do we look for with an erect chest
Free air under diaphragm
First line and very useful if abnormal
Lateral decubitis if too ill to stand
Useful as a preoperative investigation
What is the gold standard scanning for acute abdomen
CT scanning - less mortality and decreased hospital stay is done early
Who is US very useful for?
Children and women with pelvic pain or RUQ or RIF pain
What are the 3 most important things to look for
What patients go straight to surgery
Who does not go to theatre?
Nobody with pancreatitis
Nobody with DKA
What are 5 types of colonic emergencies
Perforations (stercoral, iatrogenic, anastomotic)