Abdo pain Flashcards
What are the features of a duodenal ulcer?
Epigastric pain relieved by eating
Upper GI bleeding
Common
What is the management of a duodenal ulcer?
H. pylori eradication therapy if appropriate
PPI
Bleeding= endoscopic intervention
What are the features of a gastric ulcer?
Epigastric pain worsened by eating
Upper GI bleeding
What is the management of a gastric ulcer?
H. pylori eradication therapy if appropriate
PPI
Bleeding= endoscopic intervention
What are the features of appendicitis?
Generalised abode pain then localising to McBurney’s point
Rovsing sign +
Anorexia, tachycardia, fever
What is the management of appendicitis?
Appendicectomy
What are the features of acute pancreatitis?
Severe epigastric pain, radiating to back
Vomiting, anorexia, pyrexia
History of alcohol
What is the management of acute pancreatitis?
Supportive
Treat cause
What are the features of biliary colic?
Pain in RUQ, radiating to back and R shoulder, worse following large/fatty meal
Obstructive jaundice
What are the features of acute cholecystitis?
Continuous RUQ pain
Murphy’s sign +
History of biliary colic
Pyrexia
What is the management of acute cholecystitis?
Laparoscopic cholecystectomy
IV antibiotics
What are the features of cholangitis?
Charcot’s triad- fever, RUQ pin, jaundice
What is the management of cholangitis?
IV antibiotics
Biliary decopression
What are the features of diverticulitis?
Colicky pain in LLQ
Pyrexia
What is the management of diverticulitis?
Antibiotics
What are the features of AAA?
Severe central abdo pain radiating to back
Painful pulsatile mass
What is the management of AAA?
Endoscopic/open repair
What are the features of aortic dissection?
Sudden onset severe ripping abdo pain radiating to back
Blood pressure instability
What is the management of aortic dissection?
A= Open/endoscopic repair B= BB, analgesia
What are the features of intestinal obstruction?
Generalised abdominal pain Vomiting Distension Constipation Tinkling bowel sounds
What are the features of an ectopic pregnancy?
Constant lower abdominal pain, associated with shoulder tip pain
Vaginal bleeding
History amennorrhoea/ + pregnancy test
What is the management of an ectopic pregnancy?
Salpingectomy
Methotrexate
What are the features of renal colic?
Loin pain radiating to groin- severe, colicky
restless patient
Haematuria
What are the features of acute pyelonephritis?
Loin pain radiating to groin
Fever and rigors
What is the management of acute pyelonephritis?
Antibiotics 10-14 days
What are the features of acute urinary retention?
Suprapubic pain
Haven’t passed urine recently
Lower abdominal distension, palpable bladder
Often history of BPH
What is the management of acute urinary retention?
Catheterise
What are the features of abdominal migraine?
Episodic central abdominal pain
Other migraine features e.g. N&V
More common in children
With or without migraine/history of migraine
What are some uncommon causes of abdominal pain? 4
MI
Lower lobe pneumonia
DKA
Lead poisoning
What is done in a woman of child bearing age presenting with abdominal pain?
MUST do pregnancy test
