Acute Abdomen/Peritonitis Flashcards
Will there be free air in primary peritonitis?
Nope
Should we operate on primary peritonitis?
Nope
What is an acute abdomen?
Sudden severe abdominal pain
-Can be benign
Should we give Phernergan for abdominal pain?
Never
Why is the omentum the body’s housekeeper?
It walls of any infections and adheres to them
What is visceral pain?
- Deep
- Generalized
- Results from organ distention?
What is parietal pain?
Sharp and well-localized
-Results from peritoneum irritation from pus, bile, GI secretions
Where are receptors for visceral pain located?
-Hollow viscera or
Visceral peritoneum
What kind of nerves mediate visceral pain?
Autonomic
What kind of nerves mediate parietal pain?
Somatic nerves
Why do patients have shoulder pain after a laparotomy?
-Air trapped under diaphragm refers to shoulders
What is the rate of gradual pain?
Over several hours
What is explosive pain?
Within seconds
What is rapidly progressive pain?
1-2 hours
Which is worse: pain then N/V or N/V then pain?
Pain then N/V
-N/V then pain could be gastroenteritis
How do steroids affect pain perception?
Patients on steroids usually feel less pain d/t anti-inflammatory properties
What specific questions should we ask about a patient’s surgical history?
If they still have their: gallbladder, appendix, ovaries, uterus
What does a patient that is rigid and motionless most likely have?
Peritonitis
What does rebound tenderness indicate?
Peritoneal inflammation
Is it common for patients to have both a positive psoas sign and positive obturator sign?
No
What imaging is good to look for appendicitis?
CT with PO contrast
When so we consult a surgeon for abdominal pain?
- Peritonitis
- Ischemia
- Tender abdomen with fever and hypotension
- Incarcerated hernia
What are some causes of secondary peritonitis?
Appendicitis Salpingitis Diverticulitis Trauma Bowel perforation
Treatment of secondary peritonitis?
- IV fluids to replace fluids in peritoneal cavity
- Broad-range ABX
- Then surgery
What conditions are associated with primary peritonitis?
- Cirrhosis
- Nephrotic syndrome
- SLE
What is source of primary peritonitis infection?
-Hematogenous spread
Treatment for primary peritonitis?
ABX
