Abdomen Flashcards

1
Q

How do you look for bowel perforation

A

Erect CXR

Look for gas (black) under the diaphragm

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2
Q

Is it normal to see gas in the stomach

A

Yes

This is known as the gastric bubble

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3
Q

List some of the complications of pancreatitis

A

abscess, pseudocyst, thrombosis of the splenic vein, pseudoaneurysm and haemorrhage of one of the surrounding arteries (coeliac vessels)

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4
Q

What are the primary and secondary abdominal imaging techniques

A

Primary abdominal imaging: XR, CT, USS

Secondary: MRI, fluoroscopy

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5
Q

Which patients may not tolerate the IV contrast used in CT

A

those with renal impairment - as the contrast affects the kidneys
Allergies

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6
Q

Which test can be used to exclude bowel obstruction and perforation

A

X-ray

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7
Q

What is the risk of using CT

A

Radiation exposure

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8
Q

How do you confirm a diagnose of appendicitis

A

USS first then CT if inconclusive

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9
Q

How does appendicitis present

A

Periumbilical pain which then localises to the RIF

Nausea and vomiting

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10
Q

What does gas in the bladder suggest

A

Colo-vesical fistula

Air should not be able to get into the bladder

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11
Q

How do you diagnose acute cholecystitis

A

One local sign of inflammation (RUQ pain etc)
One sign of inflammation (fever ,WCC, CRP)
Confirmatory imaging - USS

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12
Q

What is MRCP

A

MRI imaging of the biliary system - uses contrast

Used to look for gallstones

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13
Q

What is emphysematous cholecystitis

A

Air in gallbladder wall

Rare form of cholecystitis seen in diabetics

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14
Q

What are the signs and symptoms of small bowel obstruction

A

Vomiting, pain and distension

Increased bowel sounds, tenderness, palpable loops (only in thin patients)

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15
Q

What are the common causes of small bowel obstruction

A

adhesions, cancer, hernia and gallstone ileus

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16
Q

How can you treat small bowel obstruction

A

Conservative – drip and suck (IV fluids and NG tube to decompress stomach)
Or surgery if severe

17
Q

What are the common causes of large bowel obstruction

A

Colorectal cancer is most common
Volvulus
Diverticulitis

18
Q

How does bowel ischaemia present

A

Severe abdominal pain
Vomiting, diarrhoea, distension inconsistent
Borderline amylase, raised WCC, acidotic

19
Q

How can you investigate bowel ischemia

A

Biphasic CT

Arterial and Venous phase CTs - assesses both vessel types

20
Q

How is an aortic balloon used

A

If there is a ruptured/leaking AAA

Put balloon into the aorta via the femoral artery and inflate – this is just to buy you time and stop the bleed