The Acute Abdomen Flashcards Preview

Alimentary System > The Acute Abdomen > Flashcards

Flashcards in The Acute Abdomen Deck (14):
1

What is the acute abdomen?

A combination of symptoms and signs, including abdominal pain, which results in a patient being referred for an urgent general surgical opinion.

2

What three things need to be considered when a patient presents with acute abdomen symptoms?

Peritonitis
Intestinal obstruction
Abdominal pain (type)

3

Where might a peritonitis infection occur from?

GI/biliary tract perforation
Female genital tract infection
Penetration of abdominal wall
Haematogenous spread

4

When does generalised peritonitis occur?

When contamination is too rapid, contamination persists or an abscess ruptures

5

What are the typical presentations of intestinal obstruction?

Pain
Vomiting
Distension
Constipation
Borborygmi (stomach rumbling)

6

What are the three types of abdominal pain?

Visceral
Somatic
Referred

7

Why is it important to determine the type of pain?

Visceral pain gives poor localisation while somatic pain gives accurate localisation but referred pain may occur in the same location.

8

Give 6 differential diagnoses for acute abdomen

Acute appendicitis
Acute cholecystitis/colic
Peptic ulcer perforation
Urinary retention
Acute pancreatitis
Small or large bowel obstruction
Trauma
Urinary stones
Acute diverticulitis
Malignancy
Medical disorders
Vascular conditions
Gynaecological conditions

9

What should be covered in the clinical assessment of a patient presenting with acute abdomen symptoms?

What the problem is and what its effects are
History
Examination
Investigation
Consider patients capacity and level of care required

10

What are the five stages involved in the management of a patient presenting with acute abdomen symptoms?

Assess
Resuscitate
Investigate
Observe
Treat

11

What should be done in the resuscitation of a patient presenting with acute abdomen symptoms?

Restore circulating fluid volume
Ensure tissue perfusion
Enhance tissue oxygenation
Treat sepsis
Decompress gut
ensure adequate pain relief

12

What tests should be done in the investigation of a patient presenting with acute abdomen symptoms?

Ward tests - urine
Lab tests - FBC, LFTs, U&Es
Radiology - plain, US and CT
Laparoscopy vs. laparotomy

13

When is observation of a patient presenting with acute abdomen symptoms useful?

When diagnosis is uncertain and the risk of alternative intervention is greater

14

What are the treatment options for patients presenting with acute abdomen symptoms?

Definitive surgery once diagnosis is reached
Treatment of sepsis and any underlying causes