Acute Abdomen

Question 1

What symptoms are seen in an acute ischaemic bowel?

Answer 1

• unwell
• sudden, severe, constant abdo pain
• may be small amount of PR bleeding

Question 2

What are the risk factors for ischaemic bowel?

Answer 2

• AF
• PMH ischaemic heart disease
• Increased Hb

Question 3

What is commonly found on examination of an acute ischaemic bowel?

Answer 3

Pain out of proportion to physical findings.

Question 4

What test result findings indicate acute ischaemic bowel?

Answer 4

• metabolic lactate acidosis
• raised WCC
• raised amylase

Question 5

Which imaging modalities are useful in diagnosing acute ischaemic bowel?

Answer 5

• CXR to rule out perforation

- Contrast CT/CT angiography to confirm diagnosis

Question 6

How is an acute ischaemic bowel managed?

Answer 6

• NBM (reduced blood demand)
• fluid restriction
• analgesia
• IV antibiotics
• NG decompression
• referral to surgery for possible bowel resection and/or revacularisation by interventional radiology plus decision on anti-coagulation.

THE PROGNOSIS IS POOR.