Acute Abdomen Flashcards
what are the typical symptoms of an acute abdomen?
- severe, sudden onset abdominal pain
- nausea + vomiting
- change in bowel habit
what are the findings on examination of an acute abdomen?
- abdominal tenderness
- peritoneal signs
- abdominal distension
- altered bowel sounds
- irreducible hernia
what is the pattern of abdominal pain for appendicitis?
migratory pain, initially periumbilical to right iliac fossa
what is the pattern of abdominal pain for mechanical bowel obstruction?
colicky, often intermittent
what is the pattern of abdominal pain for diverticulitis?
left lower quadrant pain
what is the pattern of abdominal pain for acute pancreatitis?
epigastric pain radiating to the back
what is the pattern of abdominal pain for acute cholecystitis?
right upper quadrant pain radiating to the right shoulder or back, triggered by eating fatty foods
what is the pattern of abdominal pain for ureteric/renal colic?
colicky, ‘loin to groin’ pain
what is the pattern of abdominal pain for ovarian torsion?
sharp lower quadrant pain radiating to the leg or back on the affected side
what is the pattern of abdominal pain for aortic dissection?
sudden tearing pain radiating to the back between shoulder blades
what are the investigations for an acute abdomen?
- urinalysis
- urine β-hCG
- ECG
- FBC
- U&Es
- LFTs
- CRP
- amylase
what imaging is required for an acute abdomen?
CT abdomen + pelvis
what imaging is required for cholelithiasis?
US abdomen
what imaging is required for acute cholecystitis?
US abdomen
what imaging is required for acute pancreatitis?
US abdomen
what imaging is required for nephrolithiasis?
non-contrast CT abdomen + pelvis
what imaging is required for mesenteric ischaemia?
CT angiogram
what imaging is required for an acute abdomen if the patient is pregnant?
US/MRI abdomen + pelvis
what is the initial management of an acute abdomen?
- ABCDE
- NBM
- IV fluids
- broad-spectrum antibiotics
- analgesia
- antiemetic
- NGT
- urinary catheter
