acute abdomen Flashcards
organs that become inflamed commonly
- appendix
- gallbladder
- colon
- fallopian tube
- pancreast
what is diverticulitis?
inflammation of the colon
what is salpingitis?
inflammation of the fallopian tube
organs that become obstructed commonly
intestine
gallbladder/bile
ureter
urethra/bladder
organs that become ischaemic commonly
intestine (strangulated hernia)
ovary
organs that become perforated commonly
duodenum
stomach
colon
gallbladder
history: nausea, vomiting, central abdo pain which later shifts to the right iliac fossa
examination: fever, tenderness, guarding or palpable mass in the right iliac fossa
acute appendicitis
history: vomiting at onset associated with severe acute onset abdo pain, previous history of dyspepsia, ulcer disease, NSAIDS or corticosteroid therapy
examination: shallow breathing with minimal abdo wall movement, abdo tenderness and guarding
perforated peptic ulcer with acute peritonitis
history: anorexia, nausea, vomiting, constant severe epigastric pain, previous alcohol abuse
examination: fever, periumbilical or loin bruising, epigastric tenderness, variable guarding, reduced or absent bowel sounds
acute pancreatitis
history: sudden onset of severe, tearing back/loin/abdo pain, hypotension and past history of vascular disease and hypertension
examination: shock and hypotension, pulsatile, tender, abdominal mass, asymmetrical femoral pulses
ruptured aortic aneurysm
history: anorexia, nausea, vomiting, bloody diarrhoea, constant abdo pain, previous history of vascular disease and hypertension
examination: atrial fibrillation, heart failure, asymmetrical peripheral pulses, absent bowel sounds, variable tenderness and guarding
acute mesenteric ischaemia
history: colicky central abdo pain, nausea, vomiting and contsipation
exam: surgical scars, hernias, mass, distension, visible peristalis
intestinal obstruction
history: premenopausal, delayed or missed menstrual period, hypotension, unilateral iliac fossa pain, pleuritic shoulder tip pain, prune juice like vaginal discharge
examination: suprapubic tenderness, periumbilical bruising, pain and tenderness on vaginal examination
ruptured ectopic pregnancy
history: sexually active young female, previous STI, recent gynaecological procedure, irregular menstruation, right upper quadrant pain,
examination: fever, vaginal discharge, pelvic peritonitis causing tenderness on rectal examination, swelling/fullness in the fornix on vaginal examination
pelvic inflammatory disease
what is Murphy’s sign associated with?
acute cholecystitis
what is Rovsing’s sign?
palpation in the left iliac fossa produced pain in the right iliac fossa
what is Roving’s sign associated with?
acute appendicitis
