The acute abdomen Flashcards Preview

Gastro > The acute abdomen > Flashcards

Flashcards in The acute abdomen Deck (32):
1

What is an acute abdomen

Abdominal pain which has been around for less than 10 days
Causing severe morbidity or threat to life

2

Who does it present to?

GP
A&E
General surgeons
Gynae
General Medicine

3

What are some of the common causes of acute abdomen

Non-specific abdominal Pain (1/3rd of patients)
Acute appendicitis
Intestinal obstruction
Urological causes
Gallstone disease
Diverticular disease of the colon
Trauma
Malignancy
Perforated ulcer
Pancreatitis
IBS
Bacterial and viral infections
Gynae things

4

What are the ages for women of child-bearing age?

10-55

5

What are some of the less common causes of acute abdomen

Ruptured or symptomatic AAA
IBD
Medical causes
Ischemic gut

6

What is Munchhausen's syndrome

Attention - making something up

7

What are drug seekers?

Typically women who want morphine who are manipulating

8

3 types of abdominal pain

Visceral
Parietal
Extra-abdominal

9

5 associated symptoms of abdominal pain

Nausea/ Vomiting
Burping
Heartburn / indigestion
Change in bowel habit
PR blood / mucus

10

In what condition will the pain totally disappear?

Renal colic

11

What are the 9 regions of the abdomen

Right and Left Hypochondrian
Epigastric
Right and Left Lumbar
Umbilical
Right and Left iliac fossa
Suprapubic

12

What questions do you ask about vomit?

Colour
Green or foodstuff
Projectile
Blood
Coffee

13

What is golden yellow vomit

Digested bile

14

What colour is digested bile

Green

15

What is localised peritonism

Localised pain and guarding

16

What is peritonitis

Refers to pain in all 4 quadrants

17

What does generalised peritonitis

Board like
Usually perforated duodenal ulcer

18

Describe the bowel sounds in ileus

Absent

19

What is the common analgesia given?

IV morphine with anti-emetic
IV paracetamol

20

What is Cullen's sign

Periumbilical bruising often with Pancreatitis

21

What are initial investigations for abdomen?

Bloods: FBC,LFT,UE, CRP, Ca, Lactate, Coag
AMYLASE!!!!!
ABGs
Plain radiology
AXR and erect if possible CXR
Or straight to CT

22

Why is amylase so important to do?

Pancreatitis

23

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
Excludes pneumonia
Useful as a preoperative investigation

24

What is the gold standard scanning for acute abdomen

CT scanning - less mortality and decreased hospital stay is done early

25

Who is US very useful for?

Children and women with pelvic pain or RUQ or RIF pain

26

What are the 3 most important things to look for

Exclude pancreatitis
AAA

27

What patients go straight to surgery

ruptured AAA
ischaemic guts
Faecal peritonitis

28

Who does not go to theatre?

Nobody with pancreatitis
Nobody with DKA

29

What are 5 types of colonic emergencies

Obstruction
Volvulus
Acute diverticulitis
Toxic colitis
Perforations (stercoral, iatrogenic, anastomotic)

30

How is a volvulus managed

Decompress using rigid sigmoidoscope

31

What is typhilitis

A condition common in patients on chemotherapy

32

What is a Hartmann's procedure

surgical resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy. It was used to treat colon cancer or diverticulitis.

Decks in Gastro Class (67):