Acute Abdo Tutorial - Sai Flashcards
Where does pain from the foregut, midgut and hind gut refer to?
Foregut - epigastric pain
Midgut - periumbilical pain
Hindgut - suprapubic
Inflammatory vs obstructive pain - describe
Obstructive pain - colicky, maybe associated with constipation and nausea
Inflammatory pain - fever, systemic symptoms, constant
Boundaries of foregut
Mouth to second part of duodenum
Boundaries of the midgut
Second part of duodenum to 2/3 along transverse colon
What might you see on an X-ray for someone with perforated appendicitis?
Pneumoperitoneum
Most common cause of small bowel obstructions
Adhesions resulting from surgery incl. caesareans
What is a gallstone ileus?
When a gallstone goes and lodges through biliary-ileus fistula
Which type of hernia is a most common cause of small bowel obstruction?
Inguinal hernia
Which hernia is most likely to present with obstruction?
Femoral hernia due to strangulation
Valvulae vs haustra
Valvulae - go all the way across the diameter of the bowel, present in small bowel
Haustra - along the peripheries of the large bowel
What is the rule for identifying parts of the abdo X-ray?
3 - small bowel less than 3cm
6 - large bowel less than 6cm
9 - caecum less than 9cm
Alcohol history with upper abdo pain and vomiting
Acute pancreatitis
Note: could also be acute cholecystitis, though commonly RUQ
Could also be upper GI bleed but requires haematemesis
Alcohol history with upper abdo pain and vomiting and malena
GI bleed
How would acute cholecystitis present?
Inflammation of the gall bladder, therefore the pain will be CONSTANT in RUQ with fevers
How would someone present with acute cholangitis?
Fever/rigoros
RUQ pain
Jaundice
= Charcot’s triad
Cholangitis va cholecystitis
Cholangitis - inflammation of common bile duct
Cholecystitis - inflammation of gall bladder
Initial management of cholecystitis / cholangitis
Treat the sepsis ! Sepsis 6
Severe left sided loin pain on a background of non adherence to antihypertensives - what must you exclude?
Abdominal aortic aneurysm
Pyelonephritis symptoms
Fever
Dysuria
Constant loin pain
Most common cause of pyelonephritis in the elderly
E. coli
Hey things to rule out with epigastric pain
Peptic ulcer perforation
STEMI
Lower lobe pneumonia
What is ogilvie’s syndrome?
Pseudo bowel dilation without an actual cause
Two most common causes of large bowel obstruction
Bowel cancer
Diverticular disease
Diverticulitis- where is the pain
General, then localises to left iliac fossa due to being in sigmoid or rectum ?
Where is the pain in cystitis?
Bladder / suprapubic
Renal colic pain
Loin to groin
AAA where is the pain
Central abdominal OR loin
