Abdmonial Pain Flashcards
Sharp severe pain in epigastric and lt
hypochondrial , radiating to the back and
lt shoulder
• Pt position: leaning forward
Pancreatic
abdominal angina is red flag sign
of mesenteric ischemia
Pain is usually peri
umbilical
Small intestine
Cecum & appendix
Rt iliac fossa
pain
Pain in Rt hypochondrial and radiate
to
Rt shoulder or infrascapular
Biliary & hepatic pain
Uretric pain
Pain in renal angle, if ureteric it radiate to
upper medial thigh, and scrotum with severe
colics.
Lt iliac fossa pain
IBS
• Diverticulitis
• Lt sided
colitis
Exclusion of Surgical abdomen is mandatory
By History & examination & investigation
Absolute constipation
Guarding, Rigidity , Rebound tenderness
The most critical sign is absent intestinal Sounds
Medical causes of acute abdomen
Refered pain
-pneumonia
-pleurisy
-MI
Medical causes of acute abdomen renallll
Acute pyelonephritis
• 2-Pelviureteric Colics
Medical causes of acute abdomen metabolic
DkA
Hematological medical acute abdomen causes Hematological
Henoch_Schonlein purpura
• Sickle cell crisis
• PNH
• Polycythemia vera
Vascular causes of acute abdomen pain
Vasculitis (Behcet, 2ry to collagen disease)
• Abdominal angina :
• -embolic (AF)
• -atherosclerosis
Causes of abdmonial angina
embolic (AF)
• -atherosclerosisLo
Main ttt of acute abdomen pain
ABC approach, the main target is
RESUSCITATION when needed
• Then management according to the
Difference between
Acute pancreatitis and biliary colic
Raditation into back = pancree
Right sqapula =biliary
Alcohol , sitting upright releive it = pancreas
Diff between acute pancreatitis, peptic ulcers
Onset
S[icy ffod
Lateralised pain restricting movement Tenderness overlying involved vertebra
Acute
vertebral
collapse
Cramp-like pain
Vomiting
Air hunge
Dka
Hyperaesthesia in dermatomal distribution Vesicular eruption
Herpes zoster
Pain on percussion of thoracic spine
Hyperaesthesia at affected dermatome with
sensory loss below
Spinal cord signs
Cord compression
Sudden onset of severe, tearing backloin/abdominal pain, hypotension and past history of vascular disease and/or high blood pressure
Ruptured aortic aneurysm
Colicky entral abdominal pain, nausea, vomiting and constipation
Surgical scars, hernias, mass, distension, visible peristalsis, increased bowel sounds
Io
Anorexia, nausea, vomiting, bloody di arrhoea, constant abdominal pain, previous history of vascular dis ease andar
high blood pressure
Atrial fibrillation, heart falure, asymmetrical peripheral pulses, absent bowel sounds, variable tendemess and
guarding
Acute mesentric ischemia
