GI Emergencies Flashcards
What is visceral pain?
-Originates in hollow organs
-Difficult to localize
-Often described as burning, cramping or aching
-As a result of forceful contraction or distension of organ
What is pariatel/rebound pain?
-Originates from the peritoneum.
-Steady, achy type pain and more easily localized and inc. w movement.
-As a result of inflammation/ infection of peritoneum.
What is somatic pain?
-Originating from nerve tracts peripherally.
-Pain is well localized and usually felt deeper.
-Irritation or injury to tissues activate those nerve tracts
What is referred pain?
-Originates from nerve tracts peripherally.
-From pain in the abdomen causing a pain in distant areas as a result of similar nerve pathways between the abdomen and the distant area
What is appendicitis?
-Collection of material/feces in the appendix impeding blood flow and lymph fluids resulting in local infection, inflammation and potentially rupture.
-More common in kids but more serious in adults.
-Will Present visceral type periumbilical pain moving to RLQ with nausea and low-grade fever.
-Rebound tenderness suggests perforation/ peritonitis.
-Treat underlying pain/nausea and be vigilant for the presence of septic shock.
What is a bowel obstruction?
-Obstructed GI tract from tumour, narrowing, blockage etc.
-Pt will c/o diarrhea initially then constipation, cramping pain, NV (vomit/breath may smell
of feces)
-Absent bowel sounds (late)
-Perf. is possible and could lead to sepsis/ peritonitis.
-Treat pain and be vigilant for rupture/sepsis.
What is cholecystitis?
-Caused by blockage of cystic duct (gall bladder to duodenum) usually by gallstones.
-RUQ pain alone suggests biliary colic with progression to NV, fever, jaundice and tachycardia suggesting inflammation of GB (cholecystitis).
-Treat pain, NV and hypovolemia and be aware of potential for sepsis
What is diverticulitis?
-Increased in pressure in the intestine results in bulges in the colon generally where arteries enter.
-As feces passes by it may get lodged and fester over time causing infection and inflammation.
-Generally assoc. w cramping pain in the lower abdo and may lead to sepsis.
-Treatment is reserved to managing pain, NV and potential sepsis. Perforation is possible.
What is pancreatitis?
-When the duct that carries enzymes from the pancreas becomes blocked the enzymes begin to digest the organ itself.
-Symptoms include severe epigastric/RUQ pain w rad. to back, fever, NV, tachy, hypo-T and muscle spasm (hypocalcemia).
-Can lead to internal hemorrhage (vessel destruction).
-Treat pain and assoc. NV and be aware of shock (hypovolemia)
What is gastroenteritis?
-Broad term for collection of infectious conditions from bacterial, viral or parasitic origins resulting in NVD, fever, chills and cramping.
-Treat potential dehydration with fluids (watch for orthostatic v/s), NV and potential assoc.pain.
What is Crohn’s disease?
-Falls under the umbrella term inflam. bowel disease.
-Immune system will attack the GI tract (usually the ileum) causing damage leading to narrowing, stiffening and weakness.
-Causes recurrent flares of pain, rectal bleeding, weight loss, diarrhea and/or fever.
-Tx will focus on pain mgmt., NV and fluid resuscitation if indicated.
What is a peptic ulcer?
-Areas of high acidity (stomach, duodenum) are susceptible to having inner lining destroyed caused by infection (H pylori), ETOH, NSAID use.
-Presents w burning/ gnawing pain in abdo that stops immed. After eating the resurfaces 2-3 hrs later, NV, heartburn with severe cases leading to bleeding, perforation (peritonitis).
-Watch for hypovolemia (orthostatic v/s) and fluid resusc. If necessary
What is esophageal varices?
-Liver damage and portal HTN causes inc. pressure in distal esophageal vessels.
-May present w throat discomfort, copious amts of bright red hematemesis, hypo-T and shock.
-Potential to deteriorate very quickly. Treat with fluid resusc. Watch for shock and altered LOA indicating a rapidly worsening condition.
What is acute hepatitis?
-Damage to the liver as a result of viral infection presenting with NV, fever, pain (RUQ) and jaundice and may lead to cirrhosis.
-Hep can be transmitted via bodily builds so use appropriate PPE and cleaning.
-Treat pain and NV accordingly but be aware liver disease causes disturbances in how medications are metabolized.
What is renal colic?
-Build of salts cause stones to form.
-Pain is generally sharp and severe and in the flanks w radiation into or toward the groin.
-Symptoms include NV, inc. frequency and urgency of urination, dysuria, hematuria.
-Assess for family or personal Hx of same condition.
-Treat pain and assoc. NV
