Differentials for acute presentations - Abdominal pain Flashcards
What are life threatening causes of acute abdominal pain?
- Peritonitis
- AAA
- Ischaemic bowel
- Medical causes (DKA, Pneumonia, MI, Addisonian crisis)
How would you explore acute abdominal pain?
SOCRATES
What would you want to ask about on systemic enquiry in someone with acute abdominal pain?
- How patient feels
- Fever
- Gastro - nausea, vomiting, bowel habit, blood/malaena, weight loss
- Urological - dysuria, urinary frequency
- Gynae - LMP, PV discharge, contraception, chance of pregnancy
What would you as about on PMH in someone with acute abdominal pain?
- Happened before
- Other medical conditions
- Previous surgery - particularly abdominal
What would you want to ask about on social history?
- Smoking
- Alcohol
What would you look for on examinaion in someone with acute abdominal pain?
- Inspect - movement with resps, grey turners/cullen’s sign, scars
- Guarding/rebound tenderness
- Murphy’s/Rovsig’s sign
- Liver/spleen/kidneys/AAA
- Hernias
- Percussion tenderness
- Bowel sounds
- External genetalia/PR if indicated
What bloods would you want to do in someone with acute abdominal pain?
- FBC
- U+E’s
- CRP
- LFTs
- Amylase
- INR/G&S
- Cap glucose
- Mg2+/PO4-
- VBG
What bedside tests would you consider doing in someone with acute abdominal pain?
- NEWS
- ECG
- Urine dipstick
- Urine BHCG
What imaging sould you consider doing in someone with acute abdominal pain?
- Erect CXR
- AXR
- Fast Scan
- USS/CT abdo/pelvis
What structured approach would you take to determining what investigations you are going to do in someone with acute abdominal pain?
- Bloods/Bedside
- Orifices
- X-rays/Imaging
- ECG
- Specific tests
What are surgical causes of acute abdominal pain?
- Peritonitis/perforation
- Ruptured AAA
- Appendicitis
- Gallstone disease
- Acute pancreatitis
- Diverticulitis
- Renal colic
- Bowel obstruction
- Acute mesenteric ischaemia
- Testicular torsion
- Ischaemic colitis
- Volvulus
- Strangulated hernia
- Meckels diverticulum
- Mesenteric adenitis
- Adhesions
- Hepatic abscess
- Psoas abscess
What are medical causes of acute abdominal pain?
- Gastritis
- Peptic ulcer
- Pyelonephtritis
- Gastroenteritis
- COnstipation
- Crohn’s Disease/UC
- MI
- Pneumonia
- SC crisis
- DKA
- IBS
- Budd-chiari syndrome
- Addisonian crisis
- Hypercalcaemia
- Acute intermittent porphyria
- Hepatitis
What are gynaecological causes of Acute abdominal pain?
- Ectopic pregnancy
- Ovarian Torsion
- Acute salpingitis/PID
- Ovarian cyst rupture
- Pregnancy
- Fitz-hugh-curtis syndrome
- Endometriosis
