Acute Abdomen

Question 1

Definition of acute abdomen

Answer 1

a combination of symptoms and signs including abdominal pain

Question 2

What is the result of abdominal pain

Answer 2

Referred for urgent surgical opinion

Question 3

What is the loads of aetiology of abdominal pain

Answer 3

Non-specifc pain 
Acute appendicitis
Colic 
Peptic ulcer Perforation 
Acute
Pancreitis  
Trauma 
Small bowel obstruction 
Malignancy 
Urinary stones/ retention 
acute diverticulitis

Question 4

What is the 2 main aetiologies of abdominal pain

Answer 4

Peritonitis

Intestinal obstruction

Question 5

What are the fout routes of infection for peritonitis

Answer 5

Perforation of GI
Through female genital tract
Penetration fo abdominal wall
Haemotgenous spread (blood)

Question 6

What are the 4 ways peritonitis becomes a generalised pain rather than localised

Answer 6

Contamination is rapid
Contamination persitis
Abscess ruptures
the presence of adjuvant substances

Question 7

What begin to happen to the infection in peritonitis

Answer 7

Becomes anaerobic

Question 8

How is peritonitis caused

Answer 8

By the presence of bacteria in the peritoneum

Question 9

What are the 3 ways that results in intestinal obstruction

Answer 9

Internal complete blockage from something

Build up of something on the internal wall

Pressure pushing in form the outside

Question 10

What is the cardinal features of intestinal obstruction

Answer 10

Pain
Vomiting
Distension
Constipation

Question 11

What does the cardinal features of intestinal obstruction depend upon

Answer 11

If blockage is proximal or distal

Question 12

What is the different characteristic of abdominal pain

Answer 12

Visceral or somatic

Question 13

What does visceral pain result in

Answer 13

Sympathetic upset

Question 14

Where is the pain receptor located in somatic pain

Answer 14

Parietal peritoneum or abdominal wall

• the afferent signal passes with segmental nerves

Question 15

What pain is more easily localised

Answer 15

Somatic

Question 16

How can the overall affect of peritonitis and intestinal obstruction lead to death

Answer 16

Results in fluid loss due to nausea

increasing in bacteremia

Both factors lead to the breakdown of the mucosal barrier

causing circulatory collapse

= death

Question 17

What investigations are made in abdominal pain

Answer 17

urine
FBC
U&Es
LFT

chest X-ray and abdominal X-ray,
abdominal ultrasound scan,
CT scanning
contrast studies

Laparoscopy vs lapratomy

Question 18

What is the benefit of observation

Answer 18

Useful if Diagnosis uncertain

or

useful when risk of alternative intervention is greater

Question 19

What a features of abdominal pain that need to be considered

Answer 19

Character of pain

Site of pain

Severity

If there is Systemic upset

Question 20

What happens in the resuscitation treatment of acute abdomen pain

Answer 20

Restore circulating fluid volume
Ensure tissue perfusion
Enhance tissue oxygenation
Treat sepsis
Decompress gut
Ensure adequate pain relief

Question 21

What is the treatment of acute abdomen pain

Answer 21

Surgery

Question 22

Where are visceral pain receptors located

Answer 22

Smooth muscle and runs with sympathetic fibre

Question 23

How is visceral pain caused

Answer 23

Pain receptors in the smooth muscle wall cause the abdomen to distend and contact resulting in visceral pain