Abdominal Pain Flashcards
Surgical causes of acute abdominal pain (6)
appendicitis
malrotation and volvulus
Meckel’s
testicular/ovarian torsion
strangulated hernia
intussusception
abdominal medical causes of acute abdominal pain (6)
colic-Dx of exclusion
mesenteric adenitis
gastroenteritis
pancreatitis
pyelonephritis/UTI
constipation
Systemic medical causes of acute abdominal pain (8)
HSP
lower lobe pneumonia
mumps
familial Mediterranean fever
abdominal migraine
sickle cell
recurrent abdominal pain of childhood
DKA
Presentation of acute appendicitis (5)
peri-umbilical pain>RIF as it become peritoneal; child lies still
pulse and T initially normal> low grad pyrexia
nausea, vomitting, anorexia
tachycardia=peritonism: localised tenderness, rebound, guarding
Rovsing’s sign: palpate LIF>pain in RIF
Ix for acute appendicitis (5)
Urine dip for UTI
Pregnancy test
FBC shows mild leucocytosis/normal
raised CRP
CT
Mx of acute appendicitis and complications (5)
laparoscopic appendicectomy
complications:
- wound infection
- abscess
- perforation
- adhesion
Features of mesenteric adenitis (3)
non-specific inflammation of mesenteric LNS>abdo pain
mimics appendicitis
RECENT RESP INFECTION
Presentation of mesenteric adenitis (7)
HIGH TEMPERATURE
SORE THROAT
CERVICAL LYMPHADENOPATHY
NO REBOUND TENDERNESS/GUARDING
abdominal pain
nausea, vomitting
diarrhoea
Mx of mesenteric adenitis
observation, should resolve w/o Rx
Features of infantile colic (4)
Dx of exclusion
crying >3hrs/d >3days/wk w. no obvious cause
clenched fist/drawing knees up
starts at 2wks, usually resolves by 4mo
DDx for infantile colic (6)
GORD
cow’s milk protein intolerance
incarcerated hernia
UTI
intussusception
otitis media
Infantile colic: advice for parents (6)
resolves by 3-4mo
tummy time+movement during day
feed upright and burp
reduce caffeine intake for mother
cry weaker than normal
can add coleif (lactase) to milk
Red flags for infantile colic (6)
vomitting
change in stool
irritability/lethargy
temperature
FTT
bulging fontanelles, seizures
