General surgery - Acute abdomen Flashcards
Generalised abdominal pain differentials
Peritonitis
Ruptured AAA
Intestinal obstruction
Ischaemic colitis
RUQ pain differentials
Biliary colic
Acute cholecystitis
Acute cholangitis
Epigastric pain differentials
Acute gastritis
Peptic ulcer disease
Pancreatitis
Ruptured AAA
Central abdominal pain differentials
Ruptured AAA
Intestinal obstruction
Ischaemic colitis
Early stages of appendicitis
RIF pain differentials
Acute appendicitis Ectopic pregnancy Ruptured ovarian cyst Ovarian torsion Meckel's diverticulitis
LIF pain differentials
Diverticulitis
Ectopic pregnancy
Ruptured ovarian cyst
Ovarian torsion
Loin to groin pain
Renal colic (kidney stones)
Pyelonephritis
Ruptured AAA
Testicular pain
Torsion
Epidydmo-orchitis
Signs of peritonitis
Guarding - involuntary Rigidity Rebound tenderness Cough test - abdominal pain on coughing Percussion tenderness
Peritonitis causes
Localised - caused by inflammation of the underlying organ
Generalised:
- Can be caused by perforation of an abdominal organ e.g. perforation duodenal ulcer or ruptured appendix
- Spontaneous bacterial peritonitis (infection of ascites in liver disease)
Good phrase to use when starting to talk about management of an acute presentation
I would start with an A-E approach and examination
If the patient is going to need surgery what are some investigations and management
Group and save (potentially XM if needed)
NBM
Broad differential classes for abdominal pain
GI - obstruction, gastritis, appendicitis, diverticulitis, peptic ulcer disease, Ischaemic colitis
Pancreatitis
Biliary - cholecystitis, cholangitis
Gynae - ovarian pathology, ectopic pregnancy
Testicular - torsion, E-O
Renal - colic, pyelonephritis
DON’T FORGET RUPTURED AAA
