The acute abdomen Flashcards
What is the definition of the acute abdomen?
A combination of symptoms and signs, including abdominal pain, which results in a patient being referred for an urgent general surgical option
What are some causes of acute abdomen?
acute appendicitis, non specific pain, colic, ulcer perforation, peritonitis, trauma, acute pancreatitis etc
How can peritonitis occur ( where can bacteria enter from)
female genital tract
abdominal wall perforated
blood spread
perforated GI/biliary tract
Are aerobes or anaerobes more predominant in abscess?
anaerobes
What type of cells make up the peritoneum and what activity does this allow?
mesothelium - fibrinolytic activity to avoid friction
Name 3 ways peritonitis can become generalised from localised
perforation of abscess
contamination is rapid and persists
Name the 3 ways of obstruction
inside the tube, outside the tube and on the wall
Name some symptoms of intestinal obstruction
pain, vomiting, distension, constipation, borborygmi
What is borborygmi?
Rumbling noise of fluid/gas in abdomen
Name the 3 types of pain
visceral, somatic, referred
Does visceral or systemic pain show signs of systemic upset?
visceral
Where is the origin of somatic pain?
body wall eg muscle
Explain how somatic/referred pain is more localised than visceral
Afferent signals travel with segmented nerves and receptors in the parietal peritoneum or abdominal wall
Can somatic pain come from a visceral origin?
yes
Explain briefly with use of a pathway how peritonitis and intestinal obstruction can lead to death
Can lead to fluid loss and bacteraemia/endotoxaemia
decrease peripheral resistance
circulatory collapse
death
