Acute Abdomen Flashcards
Definition of acute abdomen
a combination of symptoms and signs including abdominal pain
What is the result of abdominal pain
Referred for urgent surgical opinion
What is the loads of aetiology of abdominal pain
Non-specifc pain Acute appendicitis Colic Peptic ulcer Perforation Acute Pancreitis Trauma Small bowel obstruction Malignancy Urinary stones/ retention acute diverticulitis
What is the 2 main aetiologies of abdominal pain
Peritonitis
Intestinal obstruction
What are the fout routes of infection for peritonitis
Perforation of GI
Through female genital tract
Penetration fo abdominal wall
Haemotgenous spread (blood)
What are the 4 ways peritonitis becomes a generalised pain rather than localised
Contamination is rapid
Contamination persitis
Abscess ruptures
the presence of adjuvant substances
What begin to happen to the infection in peritonitis
Becomes anaerobic
How is peritonitis caused
By the presence of bacteria in the peritoneum
What are the 3 ways that results in intestinal obstruction
Internal complete blockage from something
Build up of something on the internal wall
Pressure pushing in form the outside
What is the cardinal features of intestinal obstruction
Pain
Vomiting
Distension
Constipation
What does the cardinal features of intestinal obstruction depend upon
If blockage is proximal or distal
What is the different characteristic of abdominal pain
Visceral or somatic
What does visceral pain result in
Sympathetic upset
Where is the pain receptor located in somatic pain
Parietal peritoneum or abdominal wall
- the afferent signal passes with segmental nerves
What pain is more easily localised
Somatic
How can the overall affect of peritonitis and intestinal obstruction lead to death
Results in fluid loss due to nausea
increasing in bacteremia
Both factors lead to the breakdown of the mucosal barrier
causing circulatory collapse
= death
What investigations are made in abdominal pain
urine
FBC
U&Es
LFT
chest X-ray and abdominal X-ray,
abdominal ultrasound scan,
CT scanning
contrast studies
Laparoscopy vs lapratomy
What is the benefit of observation
Useful if Diagnosis uncertain
or
useful when risk of alternative intervention is greater
What a features of abdominal pain that need to be considered
Character of pain
Site of pain
Severity
If there is Systemic upset
What happens in the resuscitation treatment of acute abdomen pain
Restore circulating fluid volume Ensure tissue perfusion Enhance tissue oxygenation Treat sepsis Decompress gut Ensure adequate pain relief
What is the treatment of acute abdomen pain
Surgery
Where are visceral pain receptors located
Smooth muscle and runs with sympathetic fibre
How is visceral pain caused
Pain receptors in the smooth muscle wall cause the abdomen to distend and contact resulting in visceral pain
