Acute Abdomen

Question 1

Generalised abdominal pain

Answer 1

Peritonitis
Ruptured abdominal aortic aneurysm
Intestinal obstruction
Ischaemic colitis

Question 2

RUQ pain

Answer 2

Biliary colic
Acute cholecystitis
Acute cholangitis
Hepatitis

Question 3

Epigastric pain

Answer 3

Acute gastritis
Peptic ulcer disease
Pancreatitis
Ruptured abdominal aortic aneurysm
Biliary colic
MI
Pneumonia

Question 4

Central abdominal pain

Answer 4

Ruptured abdominal aortic aneurysm
Intestinal obstruction
Ischaemic colitis
Early stages of appendicitis

Question 5

RIF pain

Answer 5

Acute appendicitis
Ectopic pregnancy
Ruptured ovarian cyst
Ovarian torsion
Meckel’s diverticulitis

Question 6

LIF pain

Answer 6

Diverticulitis
Ectopic pregnancy
Ruptured ovarian cyst
Ovarian torsion

Question 7

Suprapubic pain

Answer 7

Lower urinary tract infection
Acute urinary retention
Pelvic inflammatory disease
Prostatitis

Question 8

Loin to groin pain

Answer 8

Renal colic (kidney stones)
Ruptured abdominal aortic aneurysm
Pyelonephritis

Question 9

Testicular pain

Answer 9

Testicular torsion
Epididymo-orchitis

Question 10

Describe the ABCDE approach in the initial assessment of acutely unwell patients

Answer 10

A – Airway: Ensure the patient’s airway is patent and secure.
B – Breathing: Assess the breathing, respiratory rate and oxygen saturations. Listen to the lungs. Provide oxygen if required.
C – Circulation: Assess the blood pressure, heart rate, heart sounds and perfusion (e.g., capillary refill time). Gain IV access (wide-bore cannulae are better), take bloods and provide an IV bolus of fluid if required.
D – Disability: Assess the consciousness level using AVPU or GCS scoring systems. Check the blood glucose level.
E – Exposure: Finish the full assessment, including examination of the abdomen.