Acute abdomen Flashcards
What is an acute abdomen
Rapid onset of severe symptoms that may indicate potentially life threatening intra abdominal- normally a 1 day history but can be up to a week
Normal history of acute abdomen
Backgroud of previous surgery or intra abdominal pathology
Associated symptoms of nausea, vomiting, diarrorhoea, jaundice, fever and PR bleeding
Systemtatic first step to dealing with acute abdomen
ABCDE
Airway- is patient speaking, groaning
Breathing- O2 sats, RR, auscultation of lung fields
Circulation- BP, HR, ECG, heart sounds
Disability- GCS, pupillary reflex, glucose
Exposure
Second step to dealing with acute abdomen
Take history
What to ask if presenting complaint abdo pain
SOCRATES
What to ask if presenting complaing nausea and vomiting
Triggers
Amount
Frequency
Colour
What are red flags in abdo history
A norexia L oss of weight/ Lump A naemia- may mention tiredness, think of other symptoms R ecent progressive history M alaena/haematemesis S wallowing difficulty
Third step to dealing with abdo exam
Examination
What will you hear on auscultation for obstruction
Tingling/reduced
What can trick you about upper flank pain
Pneumonia
Heart attack
What is called when feel right lower quadrant pain when palpating left lower quadrant
Rosvings sign- appendicitis
Step 4 dealing with acute abdomen
Bedside investigation bloods- everything Orifices- urine dipstick. pregnancy test, stool culture Xray ECG Specialist scanning
What can cause small bowel obstruction
Crohns Tumours Hernias Adhesions Radiation enteritis Ileus- gallstone Bezoar Volvulus
What is ileus gallstone
Fistula between gall bladder and bowel
What is bezoar
When psych patients eat their hair which can block small bowel
