Acute Abdominal

Question 1

Two main patterns constituting urgent general surgery referrals are

Answer 1

Peritonitis

Obstruction

Question 2

Ix for Acute abdomin

Answer 2

Key test for specific Dx: ALP, ALT, AST, Bilirubin, Amylase/lipase, Urinalysis, B-hug, Troponins, Lactose
Key test for OR preparation: FBC, U and E, BUN, Creatinine, glucose, CXR and ECG and INR/PTT

Question 3

Acute abdominal pain with RUQ

Answer 3

Hepatobiliary: Biliary colic, Cholecystitis, Cholangitis, CBD obstruction, Hepatitis, Budd-Chiari, Hepatic abscess/mass, R sub phrenic abscess
GI: Pancreatitis, intestinal pathology
Genitourinary: Nephrolithiasis, Pyelonephritis, Renal:mass, ischemia, trauma.
CV/Resp: RLL pneumonia, effusion/emphysema, CHF, MI, pericarditis, pleuritis
Miscellaneous: Herpes zoster, trauma, costochondritis

Question 4

DDX for RLQ abdo pain

Answer 4

GI: Appendicitis, Crohn’s disease, TB of ileocecal junction, Cacal tumour, Intussusception, Mesenteric lymphadenitis, Cecal diverticulitis, Cecal volvulus, Hernia,
Gynaecological: Ectopic, PID, Endometriosis, Threatened/incomplete abortion, Hydrosalpinx/salpingitis, Ovarian torsion, Hemorrhagic fibroid, Gyn tumour.
Genitourinary: Cystitis, urinary colic, epididymitis, testicular torsion, Acute urinary retention
Exztraperitoneal: Abdo wall hematoma/abscess, psoas abscess.

Question 5

DDX for abdo pain in Epigastric region

Answer 5

Cardiac: aortic dissection/rupture AAA, MI, Pericarditis
GI: Gastritis, GERD/esophagitis, PUD, Pancreatitis, Mallory-Weiss tear.

Question 6

DDX for abdo pain of LUQ

Answer 6

Pancreatic: Pancreatitis, pseudocyst, tumour
GI: Gastritis, PUD,
Splenic: Infarct, abscess, Splenomegaly, rupture, aneurysm.
Cardiopulmonary: LLL pneumonia, Effusion, empyema, MI, Pericarditis, Pleuritis
Genitourinary: Nephrolithiasis, Pyelonephritis, Renal: Mass, ischemia, trauma.