Abdominal pain

Question 1

pasien datang dengan nyeri perut, perlu identifkasi kondisi penyebab nya apa?

Answer 1

1. potentially life-threatening
2. organ threatening

Question 2

apa penyebab dari nyeri perut dengan potential life-threatening?

Answer 2

1. ec intraabdominal
2. ec extraabdominal

Question 3

dd abdominal pain pada intraabdominal dengan life-threatening?

Answer 3

• perforasi ulkus peptikum
• obstruksi intestinal
• aorta dissection
• appendicitis
• pancreatitis
• peritonitis
• ischemic bowel
• ectopic pregnancy
• hepatobiliary sepsis

Question 4

dd abdominal pain pada extraabdominal dengan life-threatening?

Answer 4

• infark miokard akut
• pneumonia (lower-lobe)
• emboli pulmo (basal)
• diabetic ketoacidosis

Question 5

manajemen pada pasien abdominal pain?

Answer 5

1. ABC (maintain stable hemodynamic)
2. Penunjang: ecg, Lab (GXM, pregnancy test, etc), USG, Abdominal XRay (AXR)
3. Analgesik: opioid (severe pain), tramadol/NSAID (moderate pain)
4. Antibiotik IV: pada sepsis

Question 6

dd nyeri perut di hipocondriac dextra

Answer 6

febrile:
1. ec surgical: hepatobiliary sepsis, abses hepar, diverticulitis
2. ec medical: hepatitis, pneumonia/empyema, pyelonephritis

afebrile:
- colic billiary
- ruptur hepatoma
- nyeri alih dari chest pathologies

Question 7

dd nyeri perut di pinggang atas (flank pain)

Answer 7

• colic ureter
• pyelonephritis
• abdominal aorta aneurysm
• splenic pathology

Question 8

dd nyeri perut bawah

Answer 8

utama: appendicitis (laki) dan ectopic pregnancy (wanita)

• diverculitis
• GI malignancy

Question 9

dd nyeri perut di epigastric

Answer 9

ec surgical: perforasi hollow viscus, akut billiary, abses hepar, pancreatitis, AAA, diseksi aorta

ec medical: inferior STEMI, DKA, peptic ulcer

Question 10

dd nyeri perut di central (colicky central abdominal pain)

Answer 10

• akut gastroenteritis
• obstruksi intestinal (large or small bowel); hernia, adhesion, malignancy
• mesenteric ischaemia