Abdominal Pain Algorithm Flashcards
Immediate Laparotomy
Ruptured Abdominal Aneurysm Ruptured ectopic pregnancy Spontaneous hepatic or splenic rupture Blunt Penetrating trauma Hemoperitoneum
3Ps for penetrating trauma
Platysma (neck
Pleura (chest)
Peritoneum (abdomen)
Urgent Surgical Abdomen
Perforated Viscus Appendicitis Meckel's Diverticulitis Strangulated Hernia Mesenteric Ischemia Unruptured Ectopic Pregnancy
Requires Early laparotomy
Uncomplicated intestinal obstruction
Uncomplicated acute cholecystitis
Uncomplicated acute diverticulitis on non-strangulated incarcerated hernia
Candidate for Elective laparotomy
PUD
Pancreatitis
Endometriosis
Inflammatory Bowel Disease
Non-surgical Abdomen
Provide Narcotic Analgesia
Observe patient
reevaluate periodically
investigative studies
Four Classification of Abdominal Pain
Peritonitis
Bowel Obstruction
Abdominal Vascular Catastrophe
Non-specific Abdominal Pain
Peritonitis (localized)
acute appendicits
cholecystitis
diverticulitis
Peritonitis (general)
perforated viscus
bowel obstruction
strangulated hernia
volvulus
Abdominal Vascular catastrophe
Abdominal Aortic Aneurysm
Acute mesenteric infarction
Non-specific abdominal pain
drug induced constipation acute gastroenteritis acute MI Lower lobe pneumonia
APACHE II Score of > or equal 15 indicates?
High severity of illness
APACHE II estimates ICU mortality based on lab values and patient signs
Aaron Sign
Acute Appendicits
Balance Sign
Ruptured Spleen