Acute Abdomen

Question 1

what are the main types of pathologies in the acute abdomen?

Answer 1

inflammatory 
obstructive 
ischaemia 
perforation 
bleeding

Question 2

visceral pain presents in which areas

Answer 2

epigastric
umbilical
pubis

Question 3

right lower quadrant pain

Answer 3

acute appendicitis

Question 4

left lower quadrant pain

Answer 4

diverticulitis

Question 5

• Abdo pain <72 hours
• Vomiting 1-3 times
• Facial flush
• Tenderness concentrated on RIF
• Anterior tenderness on rectal examination – not really done for this condition
• Fever between 37.3 and 38.5
• No evidence of UTI on urine microscopy

Answer 5

acute appendicitis

Question 6

Appendicitis patients often present with knees bent - why?

Answer 6

this is because this relaxes the abdominal muscles and relieves pressure on the appendix

Question 7

what is the most common cause of acute cholecystitis?

Answer 7

gallstone obstruction of the cystic duct

Question 8

main signs of acute cholecystitis

Answer 8

• RUQ (constant) pin
• Radiates to right shoulder
• Severe tenderness in RUQ
• Often pyrexial
• Duration >24 hours
• Acalculous (meaning no stone causing acute cholecystitis, most common cause is DM

Question 9

main signs of biliary colic

Answer 9

• Epigastric or RUQ pain (not so colicky)
• Radiates to back
• Moderate or absent tenderness over gallbladder
• Often normal temperature
• Duration of pain is only a few hours.

Question 10

acute abdominal distension with nausea in a virgin abdomen is likely to need

Answer 10

surgery

Question 11

most common cause of bowel obstruction

Answer 11

, most common in association with previous surgery, bowel obstruction is either simple (i.e. just a blocked lumen) or closed loop (i.e. two parts are blocked, forming a sort of half-circle of bowel).

Question 12

Bowel obstruction pain goes from

Answer 12

colicky to constant

Question 13

what is absolute constipation

Answer 13

passing nothing including flatulus