Acute Abdominal Pain Flashcards
Define acute pain
- Onset of less than 7 days
- Usually last hours to a few days
- More immediate attention is required
- Note that this could include an acute exacerbation of a chronic issue
Define chronic pain
- Lasts more than 7 days
- Usually lasts months to years
- Generally not immediately life-threatening
Determine the anatomical location of the pain in order to start determining what might be the cause.
List 3 types of pain and define them
- Visceral: Originates from the organs (transmitted by C fibres)
- Parietal/somatic: Irritation of parietal peritoneum
- Peripheral:
Examples of visceral pain
Birth
Bloating
Kidney stones
How and where is visceral pain usually perceived?
- Poorly localized, dull, diffuse, achy/cramping/burning
- Usually perceived in the midline as periumbilical or epigastric pain
Example: Onset of appendicitis
How and where is somatic/parietal pain usually perceived?
- Irritation of parietal peritoneum
- Well localized
- Sharp, stabbing, cutting
- Usually more sudden onset
- Aggravated by movement
Example: ?
Approach to abdominal pain (ER)
- Stabilize patient (ABCs before history/exam for acutely sick patients)
- Focused history
3.
I missed a bit i came in late
Classic signs of??
- McBurney’s point tenderness
- Rovsig sign
- Psoas sign
- Murphy’s sign
Palpation
- Mass, organomegaly
- Bulge
- Tenderness
- Peritoneal signs: guarding, rebound tenderness
Define guarding
Define rebound tenderness
If you press down on the right side…?
What is an acute abdomen
Urgent and surgical clinical diagnosis
When evaluating acute abdominal pain, one must rule out life-threatening etilogies such as…
- Abdominal aortic aneurysm rupture
- Ectopic pregn
First imaging investigation for abdominal pain
X-ray (but not super useful)
CT
