acute abdominal pain Flashcards
what is the definition of acute abdomen ?
it is any situation in which the patient complains of acute abdomen symptoms which suggests a disease which could be life threatening.
what are the usual causes of fatality in acute abdomen ?
sepsis (peritonitis)
acute disturbances of body fluids
what are the causes of sepsis?
rupture of a hollow viscous
external contamination
what are causes of acute disturbances of body fluids ?
haemorrhage
loss of plasma or other fluids
what are the causes of ruptured hollow viscus ?
trauma
localized pathology
post obstruction
what are the causes of haemorrhage ?
trauma
erosion of blood vessels
aneurysm
if you have a syncopal attack in a pregnant woman what would a provisional diagnosis be ?
ectopic haemorrhage until proven otherwise
what are the cause of loss of plasma or other fluids ?
early peritonitis
pancreatitis
intestinal obstructionn
what four main questions need to be addressed when you have a case of acute abdomen ?
- Is there a need for hospitalization
- Is the patient haemodynamically stable
- Onset of symptoms
- Analysis of pain
what is the absolute criteria for admitting a patient to the hospital ?
trauma
shock
disturbance of body fluids
when can we consider a referral to the hospital ?
obstruction
peritonitis
what are the different presentations of pain in acute abdomen patients ?
- intermittent periodic, gripping poorly localized
- continuous pain, worsened by movement
- others (GIT manifestation)
what are the types of continuous pain (peritonitis)?
localized
generalized
what differentiates localized peritonitis from generalized peritonitis ?
localized there are weak but present abdominal sounds
with generalized there are absent sounds
localized peritonitis and no GIT manifestations ?
gynaecological septic conditions ( salpingitis/ systemic inflammatory disease)
what does right upper quadrant pain indicate ?
acute cholecystitis ( calcular and non calcular )
what does pain in the right iliac fossa indicate ?
acute appendicitis
what does pain in the left iliac fossa indicate ?
acute diverticulitis
which is more dangerous generalized or local peritonitis?
generalized peritonitis is more serious
what are the causes of generalized peritonitis ?
acute — pancreatitis
chronic —- perforation
what type of investigations would be required for generalized peritonitis ?
serum amylase and erect chest x-ray
how do we differentiate the different causes of generalized peritonitis with investigations ?
slightly raised air under diaphragm- perforated viscus
markedly raised and no free gas - acute pancreatitis
If it is not acute pancreatitis or perforated viscus what could it be ?
vascular accidents
extension of severe inflammation
what is the cause of intermittent gripping pain ?
obstruction of hollow viscus
how is colicky pain presented (non GIT) ?
renal pain that radiates from loin to the groin
how is GIT related colicky pain presented ?
present inn the central region of the abdomen naround the umbilicus or in the suprapubic region
what is the clinical presentation with central abdominal colicky pain ?
vomiting , constipation, abdominal distention or tympanic abdomen
typical colicky loin radiate from groin to testes ?
ureteric colic
what are the causes of small intestinal obstruction ?
post-operative adhesive intestinal obstruction
hernia
small intestinal tumors
gallstone ileus
