Acute Abdomen Flashcards
Epigastric D/D
- PUD/Gastritis/Cancer
- Early Appendicitis
- Pancreatitis
- MI
- Gall Bladder Disease
- Esophageal Disease (GERD, Hernia)
Diffuse Abdominal pain D/D
GI: - Peritonitis - Mesenteric Ischemia - Bowel Obstruction - Pancreatitis - IBS/D - Gastroenteritis Systemic: - DKA - Uremia - SCD - Vasculitis - Toxin ingestion
RUQ Pain D/D
- Gall Bladder Disease
- Liver Disease
- Appendicitis
- Acute Pyelonephritis
- RLL Pneumonia
- CHF
LUQ Pain D/D
- Gastric PAth
- SPlenic infarct
- Diverticulitis/ Colitis
- Pancreatitis
- LLL Pneumonia
Periumbilical Pain D/D
- Diverticulitis
- Early appendicitis
- Ischemic Bowel
- IBD
- SBO
RLQ Pain D/D
- Appendicitis
- IBD
- Mesenteric adenitis
- Renal Colic/infarct
- Testicular Pathology
- OB/GYN PAth
- Hernia
LLQ Pain D/D
- Diverticulitis/ Colitis
- Sigmoid stricture
- Testicular/OB/GYN PAth
Right Suprapubic Pain D/D
- Sigmoid diverticulitis
- Appendicitis
- Urinary Bladder
Life-threatening Acute abdomen conditions
- AAA
- Perf isch Colitis
- Isch Bowel
- Perf PUD
- Hemorrhage
Acute Abdomen conditions “could be” life-threatening
- Appendicitis
- Cholecytectomy/lithiasis
- Sigmoid diverticulum
- Salpingitis
Acute abdomen self-limited conditions
- Gastroenteritis
- Lymphadenitis
- Epiploic appendagitis
- Omental infarct
- Cecal Diverticulitis
Tx Pneumoperitoneum
Laparoscopy/Laparatomy
Mesenteric Ischemia
- S/S: Abdominal pain; arrythmia; vascular Dx; INC WBC; Acidosis; Hypotension
- Tx: Laparoscopy/tomy
Fitz-hugh-curtis syndrome
- RUQ Advanced PUD via Chlamydia
- “Violin String” Adhesions
Most common locations Appendix
- 65% Retrocecal
- 32% Pelvic
- Patient in fetal position w/ RLQ pain
- Positive Psoas Sign
Retrocecal Appendicitis
How does appendix move during pregnancy?
Superior + Lateral
What is contraindicated in 3rd trimester
Laparoscopic appendectomy
Appendicitis XRary
- Appendicolith
- Cecal ileus
- RLQ mass effect
Diagnostic gold standard for appendicitis
CT Abdomen/Pelvis
Child Appendicitis D/D
- Gastroenteritis
- Mesenteric Lymphadenitis
- Pyelonephritis
- Meckel’s Diverticulitum
- Intussusception
- Appendicitis very uncommon <2 YO
Female Appendicitis D/D
- Obstipation
- PID
- Ruptured ectopic pregnancy
- Mittelschmerz (Ovulation pain)
- Endometriosis
- Regional enteritis
- UTI/stone
Male Appendicitis D/D
- Regional enteritis
- Epidydymo-orchitis
- UTI/Stone
Appendicitis Complications
- Phlegmon (soft tissue inflammation under skin)
- Abcess
- Bleeding
- Maceration of Cecum
