Acute abdominal conditions traumas Flashcards
Ways to describe abdominal pain by location
Diffuse
Epigastric
Periumbilical
One of the four quadrants
Friedmann Dahl position
Lateral prone X-Ray
Imaging of acute abdomen pain
X-ray can detect 2-3 mL of free air
US can detect appendicitis
CT can detect bleeding and aneurysms
Right upper quadrant pain
Liver, Bile tract, Gall bladder
Right kidney stones, UTI , or parencymal kidney damage
Method of choice for gall stones or bile tract stones
US
Inflammed gall bladder has thickened wall, multilayers and edematous.
Doppler US can reveal increased vascularization.
Left upper quadrant pain
Splenic rupture (dont forget this one)
Gastric perforation or ulcers
Aorta aneurysm
Left kidney problems
Right lower quadrant
Appendicitis
Oophoritis (ovaries)
Salpingitis
Tuboovarian abscess
Extra uterine pregnancy
Pylo-urethral stone
GI hernia
Crohns disease
Diverticulitis
GI perforation
Left lower quadrant
Sigmoid diverticulitis
Ovarian/tubule problems
Ulcerative colitis
Periumbilical pain
Acute pancreatitis
Bowel obstruction
Early appendicitis
Mesenteric ischemia
Aortic Aneurysm or Dissection
Epigastric pain
MI,
Acute pancreatitis
Hiatal Hernia
Gastric Ulcer
Imaging for acute abdominal pain or abdominal trauma
X-Ray
US
CT - modality of choice.
MR is too slow and not used for any emergency indication.
Modalities in abdominal and pelvid trauma
CT is the first choice
Ultrasound is possible but less complete than CT.
What is a sentinel loop?
A sentinel loop is a focal area of adynamic ileus close to an intra-abdominal inflammatory process.
Epigastric sentinel loop can indicate pancreatitis
Right lower quadrant sentinel loop can indicate appendicitis.
