2.2 MTB Step 3 - General (Inflammation - Acute Diverticulitis, Diverticular Abscess, Acute Pancreatitis, Acute Appendicitis, CUC) Flashcards
Cards Complete:
INFLAMMATION
What are (3) Inflammatory causes of an Acute Abdomen?
- Acute Diverticulitis
- Acute Pancreatitis
- Acute Appendicitis
INFLAMMATION
What are (2) common question Descriptions of Abdominal Inflammation?
- Gradual onset of constant abdominal pain that slowly builds up over several hours.
- Initially, ill-defined pain that eventually becomes localized to the site of inflammation.
ACUTE DIVERTICULITIS
What are (4) common Clinical Manifestations of Acute Diverticulitis?
- Middle age or Older
- Fever
- Leukocytosis
- Peritoneal Irritation/Pain in the LEFT LOWER QUADRANT with a Palpable Tender Mass
ACUTE DIVERTICULITIS
In women, what are (2) other sources of Acute Abdomen that should be considered?
- Fallopian Tubes
- Ovaries
When diagnosing acute diverticulitis, don’t forget to order a Urine Pregnancy Test on all women of childbearing age
ACUTE DIVERTICULITIS
What is the Most Common anatomical location for Diverticulosis?
Sigmoid Colon
The Sigmoid Colon has the smallest diameter and therefore the highest intraluminal pressure.
ACUTE DIVERTICULITIS
What is the Most ACCURATE Diagnostic Test for Acute Diverticulitis?
CT Abdomen w/ Contrast
- To look for Abscess or Free Air.*
- Fat Stranding is common around the inflamed bowel.*
ACUTE DIVERTICULITIS
What Exam is considered an Absolute Contraindication in Acute Diverticulitis, and why?
Colonoscopy
because it raises the risk of Perforation.
ACUTE DIVERTICULITIS
What is the Treatment for Acute Diverticulitis in a patient with NO peritoneal signs?
Manage as Outpatient with Antibiotics
ACUTE DIVERTICULITIS
What is the Treatment for Acute Diverticulitis in a patient with Localized Peritoneal Signs and Abscess?
- NPO
- IV Fluids
- IV Antibiotics
- CT-guided Percutaneous Drainage of Abscess
ACUTE DIVERTICULITIS
What is the Treatment for Acute Diverticulitis in a patient with Generalized Peritonitis or Perforation?
EMERGENCY Surgery
ACUTE DIVERTICULITIS
What is the Treatment for Acute Diverticulitis in a patient with Recurrent Attacks of Diverticulitis?
ELECTIVE Surgery
DIVERTICULAR ABSCESS
What is the Cause of Diverticular Abscess?
Pus Collecting in a Diverticular Pouch
DIVERTICULAR ABSCESS
When should you suspect a Diverticular Abscess?
Suspect a Diverticular Abscess in patients with UNCOMPLICATED DIVERTICULITIS who have one of the following despite 3 days of Antibiotic treatment:
- NO improvement in Abdominal Pain, or
- Persistent Fever
DIVERTICULAR ABSCESS
What Test is used to diagnose Diverticular Abscess?
CT Abdomen
DIVERTICULAR ABSCESS
What is the Treatment for a Diverticular Abscess?
Percutaneous or Surgical DRAINAGE
Start Antibiotics to Prevent Spread of the Infection