Acute abdominal pain Flashcards
Name as many infective causes of abdominal pain (9)
Gastroenteritis Appendicitis Diverticulitis Pyelonephritis Cholecystitis Cholangitis Pelvic inflammatory disease Hepatitis Pneumonia§
Name the two inflammatory causes of acute abdominal pain
Pancreatitis
Peptic ulcer disease
Name the 3 vascular conditions that lead to acute abdominal pain
ruptured AAA
mesenteric ischaemia
Myocardial infarction
Name 2 conditions caused by trauma which gives abdominal pain
Ruptured spleen Perforated viscus (oesophagus, stomach, bowel)
Name 2 metabolic conditions that give acute abdominal pain
renal/ureteric stone
diabetic ketoacidosis
What are the symptoms and where would you find biliary colic?
right upper quadrant
Gallstone lodged in the bile duct, provoked by eating a fat meal. No fever or inflammation
What are the symptoms and where would you find acute cholecystitis?
Right upper quadrant
Inflammation/infection of the gallbladder secondary to impacted gallstones. Murpheys sign positive - pain on palpation on RUQ
Fever and raised inflammatory markers
What are the symptoms and where would you find ascending cholangitis?
Right upper quadrant
Ascending cholangitis is a bacterial infection of the biliary tree, usually caused by gall stones
Get Charcot’s triad - RUQ pain, fever and jaundice
What are the symptoms and where would you find acute pancreatitis?
Epigastrium radiates to the back
Severe pain, tenderness, ileus and low-grade fever
What are the symptoms and where would you find a peptic ulcer disease?
Epigastrium
History of NSAID or excess alcohol use
Possible haematemesis seen
What is the distinguishing features of gastric and duodenal ulcers?
Duodenal - more common, the epigastric pain is relieved by eating
Gastric - epigastric pain is worsened by eating
What are the symptoms of appendicitis and where would find it?
right iliac fossa pain
Pain starts in the central abdomen before localising to the right iliac fossa pain
Anorexia, tachycardic, low grade pyrexia, tenderness are all common
Rovsing’s sign: more pain in RIF than LIF when palpating the LIF
What are the symptoms of acute diverticulitis and where would you find it?
Lower left quadrant
Colicky pain
Diarrhoea, sometimes with blood
Fever raised inflammatory markers and white cells
What are the symptoms of intestinal obstruction and where would you find it?
Central pain
History of malignancy or previous operations
Vomiting, not opened bowels recently
Tinkling bowel sounds
What are the symptoms of renal colic and where would you find it?
Loin pain radiating to the groin
Severe but intermittent pain, characteristically restless patient, haematuria may be present
What are the symptoms of acute pyelonephritis and where would you find it?
Loin pain
Fever, rigours and vomiting
What are the symptoms of urinary retention and where would you find it?
Suprapubic pain
Caused by obstruction to the bladder outflow
Common in men with benign prostatic hyperplasia
What are the symptoms of ectopic pregnancy and where would you find it?
Right or left iliac fossa, shoulder tip pain
Presents with pain, history of amenorrhoea for the past 6-9 weeks.
Vaginal bleeding may be present
what are the symptoms of ruptured AAA and where would you find it?
Central abdominal pain radiating to the back
History of cardiovascular disease, patients often in shock, the presentation could be sudden collapse or sub acute
What are the symptoms of mesenteric ischaemia and where would you find it?
Central abdominal pain
History of atrial fibrillation or other CVD
Metabolic acidosis is often seen due to dying tissue