1.7 Differential diagnosis of acute abdomen (with particular attention to urologic diseases) Flashcards
what is acute abdoment?
sudden onset of severe abdominal pain developing over a short time period.
urological etiology of acute abdomen?
- Renal colic (eg. due to stones)
- UTI
- Testicular torsion
- Acute urinary retention
- Cystitis
_______________________________________________ - Renal vein thrombosis
- Kidney infarction
- Pyelonephritis
- Renal abscess
- Ureteral stone
- Retroperitoneal bleeding or hematoma
- Acute prostatitis
- Congenital disorders of the upper UT
gastroIntestinal etiology of acute abdomen?
- Perforated peptic ulcer
- Acute appendicitis
- Mesenteric adenitis
- Diverticulitis
- meckel’s diverticulitis
- Gastroenteritis
- Intestinal obstruction
- Strangulated hernia
hepatobilliary etiology of acute abdomen?
- Biliary colic
- Cholecystitis
- Cholangitis= inflammation of the bile duct system
- Pancreatitis
- Hepatitis
vascular etiology of acute abdomen?
- Ruptured AAA
- Acute mesenteric ischemia
- Ischemic colitis
gynecological etiology of acute abdomen?
- Ectopic pregnancy
- Ovarian cyst (rupture, hemorrhage, torsion)
- Salpingitis
- Endometriosis
urological acute abdomen diagnosis?
- Medical history and physical examination
- Urine sediment
- Laboratory tests
- ECG
- Imaging
- Laparoscopy / laparotomy if acute intestinal or vascular disease is suspected
- Gastroscopy if melena or blood vomiting is present
characteristics of pain in acute abdomen?
location
urological diseases often in
* hypogastrium
* groin
* inner thigh
characteristics of pain in acute abdomen?
onset
Sudden (seconds)
Rapid (minutes-hours)
Gradual (hours)
what can be behind sudden onset of pain in acute abdomen?
SECONDS
- perforated ulcer
- mesenteric infarction
- ruptured AAA
- ruptured ectopic pregnancy
- ovarian torsion or ruptured cyst
what can be behind rapid pain in acute abdomen?
MINUTES-HOURS
- acute pancreatitis,
- biliary colic
- diverticulitis
- ureteral and renal colic
- strangulated hernia
- volvulus
- intussusception
Basically ALL COLICS
what can be behind gradually raising pain in acute abdomen?
MANY HOURS
- urinary retention
- cystitis,
- salpingitis
- prostatitis
- epididymitis
- orchitis
________________________________ - PUD
- appendicitis
- IBD
- strangulated hernia
- chronic pancreatitis
other symp. in acute abdomen to pay attention to?
- fever
- urgency
- difficulity voiding
- dysurea
- nausea, vomiting
- swelling
- scrotal erythma
physical signs of acute abdomen?
cullen’s sign
grey-turner’s sign
kehr’s sign
mcburney’s sign
iliopsoas sign
obturator sign
rovsing sign
murphy’s sign
chandelier’s sign
what does cullen’s sign indicates?
- periumbilical hematoma
- retroperitoneal hemorrhage:
-> hemorrhagic pancreatitis
-> ruptured AAA)
