27. Acute Abdomen Flashcards

1
Q

What is an acute abdomen?

A

Presence of signs and symptoms of inflammation in the peritoneum for less than 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the inflammatory causes of an acute abdomen?

A

Appendicitis
Diverticulitis
Pancreatitis
Cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the obstructive causes of an acute abdomen?

A

Biliary colic
Small or large bowel obstruction
Intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the perforation causes of acute abdomen?

A

Peptic ulcer

Ruptured AAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the ischaemic causes of acute abdomen?

A

Bowel/mesenteric ischaemia
Torsion
Gynaecological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes are more related to steady pain?

A

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes are more related to crampy pain?

A

Obstructive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the causes of sudden pain in an acute abdomen?

A

Perforation
Haemorrhage
Infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of gradual pain in an acute abdomen?

A

Peritoneal irritation

Distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does pain radiating to the right shoulder suggest?

A

Gall bladder related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does pain radiating to the flank or groin suggest?

A

Kidney or ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does pain radiating to the back suggest?

A

AAA
PUD
Pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the most common causes of small bowel obstruction?

A

Hernias

Adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be looked for on palpation?

A
Tenderness
Rigidity
Guarding
Masses
Also check for AAA and hernias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 3 tests will completely change the management of a patient with acute abdomen?

A

Serum amylase/lipase
B-HCG (ie a pregnancy test)
Chest X ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is an MRI used in an acute abdomen?

A

Only if the patient is pregnant

17
Q

What can be picked up on an angiography in an acute abdomen?

A

Mesenteric ischaemia

18
Q

What is the general management for a patient with an acute abdomen?

A
Oxygen
Fluids 
Analgesia
NG tube if vomiting
Urinary catheter
19
Q

What does sudden relief of pain in acute appendicitis suggest?

A

Perforation

20
Q

What is the specific management of acute appendicitis?

A

Appendicectomy

IV antibiotics are only continued if perforated

21
Q

What are the complications of acute appendicitis?

A

Perforation
RIF abscess, pelvic abscess
Adhesions
Sepsis

22
Q

How do posterior peptic ulcers present?

A

Can erode through the gastroduodenal artery, causing a haemorrhage

23
Q

How do anterior peptic ulcers present?

A

Perforation and acute abdomen

24
Q

How do perforated peptic ulcers present?

A

Intense steady pain
Patient feels they need to lie still
Well localised burning/gnawing/aching pain

25
Q

What is the management of a perforated peptic ulcer?

A

Laparotomy

Graham patch

26
Q

What is a Graham patch?

A

Ulcer is covered with omentum

27
Q

Apart from pancreatitis, what disease can increase serum amylase to 3 times normal?

A

Mumps

28
Q

How is a small bowel obstruction seen on an abdominal x ray?

A

Horizontal lines