Abdominal Catastrophes

Question 1

what region of the gut gives epigastric pain

Answer 1

foregut

Question 2

what region of the gut give periumbilical pain

Answer 2

midgut

Question 3

what region of the gut gives suprapubic pain

Answer 3

hindgut

Question 4

What is referred pain

Answer 4

Pain perceived at a site distant away from the site causing the pain

Question 5

What is visceral referred pain

Answer 5

Where visceral pain fibres follow the sympathetic fibres back to the CNS which assumes the pain is coming from these sympathetic fibres so sends the efferent pain signals along the dermatomes of the sympathetic fibres

Question 6

What pain is felt with gastritis

Answer 6

Epigastric

Question 7

Why may you get shoulder tip pain with abdominal injury

Answer 7

The injury could irritate the diaphragm which is supplied by the phrenic nerve - therefore pain is also sent over C3/4/5

Question 8

What pain would you get in acute appendicitis

Answer 8

Peri-umbilical

Question 9

What is the most common cause of acute gut ischaemia

Answer 9

Embolism caused by atrial fibrillation

Question 10

What happens to the WBC in acute gut ischaemia

Answer 10

It increases

Question 11

What is haematemasis

Answer 11

Vomiting up blood

Question 12

What is melaena

Answer 12

The alteration of blood by digestive enzymes and intestinal bacteria to produce a dark black stool

Question 13

Where in the GI does bleeding occur to give melaena

Answer 13

Upper GI tract

Question 14

What is haematochezia

Answer 14

Bright red blood in the stool

Question 15

Where does bleeding occur with a dudodenal ulcer

Answer 15

Bleeding comes through the erosion of the gastrodudenal artery

Question 16

What happens if there is perforation of the anterior stomach

Answer 16

The stomach contents will move into the lesser sac, through the epiploic foramen and into the greater sac

Question 17

What will the affect be on the blood urea level in oesophageal bleeding

Answer 17

Due to the increased amount of protein going to the liver (from the blood) there will be an increase in urea - but normal creatinine

Question 18

What will perforation of diverticulum cause

Answer 18

Sepsis

Question 19

What is a cause of intra-peritoneum bleeding

Answer 19

Ruptured ectopic pregnancy

Question 20

What does bowel obstruction result in

Answer 20

• ischaemia of the gut

- dehydration

Question 21

Why is there dehydration with bowel obstruction

Answer 21

Less water can be absorbed and more water is secreted from the ECF into the lumen to produce a hypotonic chyme

Question 22

What happens to the haematocrit in bowel obstruction

Answer 22

It is increased due to the loss of water from the ECF

Question 23

Why must precaution be given when administering anaesthetics to a patient with bowel obstruction

Answer 23

Anaesthetics drops the sympathetic tone and has a negative inotropic effect
This further decreases the blood pressure of someone who is already dehydrated so could increase damage

Question 24

What are the causes of bowel obstruction

Answer 24

Adhesions from a previous surgery 
Femoral hernias 
Volvulus 
Carcinoma 
Diverticulum disease