Acute Abdomen

Question 1

what is an acute abdomen

Answer 1

<10 days presentation
progressive intra-abdominal condition
causes severe morbidity and threat to life

Question 2

symptoms of acute abdomen

Answer 2

abdominal pain - SOCRATES
associated symptoms;
nausea/vomiting 
burping 
heart burn/indigestion 
change in bowel habit 
PR blood/mucus

Question 3

vomiting in acute abdomen

Answer 3

colour of vomit 
green or foodstuff
projectile 
blood
coffee grounds

Question 4

signs of acute abdomen

Answer 4

pain 
localised peritonism 
generalised peritonaitis 
guarding 
rebound tenderness 
roving's sign 
Cullen's 
grey turner 
erythema ab igne

Question 5

auscultation of acute abdomen

Answer 5

bowel sounds absent;
in ileum
morbid obesity

useful if they are tinkling

Question 6

treatment of acute abdomen

Answer 6

anaglesia + anti-emetic 
ABCD
urinalysis 
oxygen 
fluids 
immediate surgery or nothing

Question 7

examples of analgesia

Answer 7

morphine

paracetamol

Question 8

tests of acute abdomen

Answer 8

FBC
LFT
U&E
CRP 
Ca2+ 
lactate 
coag
amylase !!!!
ABG's

Question 9

imaging tests for acute abdomen

Answer 9

CT - or AXR/CXR

ultrasound

Question 10

CXR findings

Answer 10

excludes pneumonia

Question 11

AXR findings

Answer 11

only useful in;
obstruction
colitis
perforation

Question 12

indications for ultrasound

Answer 12

useful right upper quadrant and right iliac fossa pain

kids and woman

Question 13

complications of acute abdomen

Answer 13

pancreatitis

abdominal aortic aneurysm - presents on AXR/CXR

Question 14

treatment for duodenal ulcer perforation

Answer 14

resuscitate 
antibiotics 
\+/- surgery 
patch repair
eradicate H.pylori and PPI

Question 15

examples of colonic emergencies

Answer 15

obstruction 
volvulus
acute diverticulitis 
toxic colitis 
perforations

Question 16

treatment of volvulus

Answer 16

decompress using rigid sigmoidosocpe

Question 17

treatment of malignant obstruction

Answer 17

stent or operate

Question 18

treatment for diverticulitis

Answer 18

spectrum from antibiotic

surgery - Hartmann’s

Question 19

treatment for typhilitis

Answer 19

antibiotics or operate

Question 20

treatment for perforation

Answer 20

stercoral - Remove colon

leaks - theatre to asses and decide

Question 21

how is diverticulitis classified

Answer 21

hinchey classification

Question 22

describe hinchey classification

Answer 22

I - para colic abscess
II - pelvic abscess
III - purulent peritonitis
IV - faecal peritonitis (fatal)

Question 23

Hartmann’s procedure

Answer 23

remove sigmoid
leave rectum
bring out colostomy