A.22 Acute Abdominal Catastrophy

Question 1

A.22 Acute Abdominal Catastrophes
Definition

Answer 1

Acute abdomen refers to severe abdominal pain lasting for 5 days. It is essential to identify life-threatening causes and conduct a thorough physical examination to optimize diagnostic workup.

Question 2

A.22 Acute Abdominal Catastrophes
Red Flags for Abdominal Pain:

Answer 2

Health Changes:
* Hematemesis
* Jaundice
* Age (patients over 50 years)
* Family history of cardiac or other diseases
* Severe and persistent pain

Question 3

A.22 Acute Abdominal Catastrophes
Approach to Management:

Answer 3

• ABC (Airway, Breathing, Circulation)
• Emergency interventions for critically ill patients
• Hemodynamic and respiratory support as needed
• Assessment and preparation for possible surgical interventions

Question 4

A.22 Acute Abdominal Catastrophes
Diagnostics

Answer 4

Basic laboratory tests:
* Arterial blood gases
* Complete blood count
* Coagulation profile
* Liver function tests and blood type screening
* Additional imaging: Ultrasound, CT, or MRI based on clinical presentation and abdominal pain.

Effective management of abdominal pain requires careful initial assessment and appropriate strategies to ensure patient safety.

Question 5

A.22 Acute Abdominal Catastrophes
Specific Signs on Physical Examination

Answer 5

Tenderness:
- Campert: Pain may be elicited when the patient raises their shoulders off the table.
- Chandler: Manipulation of the cervix can evoke pain in the buttocks.
- Cullen’s Sign: Bruising around the umbilicus may indicate intra-abdominal bleeding.
- Gray-Turner’s Sign: Flank discoloration can suggest hemorrhagic pancreatitis.
Liver Examination:
- Liver palpation: Tenderness or enlargement may be noted.
McBurney’s Point:
- Tenderness in the right lower quadrant (RLQ) can indicate appendicitis, typically localized two-thirds of the distance between the anterior superior iliac spine and the umbilicus.
Rebound Tenderness:
- Pain upon rapid release after deep palpation in the RLQ may suggest peritonitis.
Rosving’s Sign:
- Pain in the RLQ when the left lower quadrant (LLQ) is palpated may indicate appendicitis.

Question 6

A.22 Acute Abdominal Catastrophes
Types of Onset:

Answer 6

Sudden Onset:
Perforation or rupture of a viscus (e.g., peptic ulcer, diverticulum).
Rapid Onset:
Conditions such as strangulation or torsion.
Gradual Onset:
Conditions like obstruction or inflammatory processes.