Acute abdomen Flashcards
What do we refer to as acute abdomen?
Combination of signs and symptoms, including abdomen pain, that result in a patient being referred for an urgent general surgical opinion
What is the peritoneum?
Dual layered semipermeable membrane with specialised lymphatics and fibrinolytic activity
What is peritoneal fluid?
Small amount of fluid in the peritoneal cavity to prevent the surfaces sticking
What is peritonitis?
Inflammation of the peritoneum
What are the routes of infection of peritonitis?
Perforation of GI/ biliary tract
Female genital tract
Perforation of abdomen wall
Haematogenous spread
What is the most likely infective organism in recent onset peritonitis?
Aerobe
What is the most likely infective organism in persistent peritonitis?
Anaerobe
When does generalised peritonitis occur?
Rapid or persistent contamination
Ruptured abscess
What are the 3 types of GI obstruction?
Inside bowel
On the bowel wall
Outside the bowel
What are the cardinal features of GI obstruction?
Pain Vomiting Distension Constipation Borbirygmi (rumbling, gurgling noise)
How can visceral abdominal pain be distinguished from other forms of pain?
Systemic upset
Poorly localised
How can somatic pain be distinguished from other types of pain?
No systemic upset
Accurate localisation
Possible referred pain
What questions should be asked when a patient presents with abdomen pain?
Site
Severity
Systemic upset
Character
What are the first steps in managing abdomen pain?
Assessment and resusitation
What is done in resuscitation with abdomen pain?
Restore circulating fluid volume Ensure tissue perforation Enhance tissue oxygenation Treat sepsis Decompress gut Ensure adequate pain relief
