L27: Acute Abdomen Flashcards

1
Q

What is an acute abdomen?

A
  • inflammation of peritoneum
  • present for < 24 hours
  • require emergency treatment
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2
Q

If a patient has STEADY abdominal pain, what is this suggestive of?

A

inflammatory process

- usually worsened by movement or coughing

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3
Q

If a patient has CRAMPY/COLICKY abdominal pain, what is this suggestive of?

A

obstructive process

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4
Q

If the abdominal pain is SUDDEN, what is this suggestive of?

A

perforation, harmorrhage or infarct…

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5
Q

If the abdominal pain is GRADUAL, what is this suggestive of?

A

peritoneal irritation, hollow organ distension…

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6
Q

If abdominal pain radiates to the right shoulder, what organ is most likely affected?

A

Gall Bladder

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7
Q

If abdominal pain radiates to around the flank to groin area, what organs/structures are most likely affected?

A

Kidney or Ureter

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8
Q

If abdominal pain radiates to the back, what are the 3 possible causes?

A
  1. AAA*
  2. Peptic Ulcer Disease
  3. Pancreatitis
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9
Q

An appendicitis usually occurs due to obstruction by a….

A

faecolith - stone made of faeces

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10
Q

Why might an appendix become gangrenous?

A

due to obliteration of appendix artery (during appendicitis)

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11
Q

Explain the distribution of pain in appendicitis

A
early = periumbilical pain
later = moves to RLQ
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12
Q

If there is a sudden relief of pain in a patient with appendicitis, what does this indicate?

A

possible perforation

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13
Q

List the 6 positions that the appendix may be found in. Which is the most common?

A
  1. Retrocaecal - most common
  2. Paracaecal
  3. Subcaecal
  4. Preileal
  5. Postileal
  6. Pelvic
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14
Q

List some of the possible complications of acute appendicitis

A
  • perforation
  • RIF abscess
  • adhesions
  • pelvic abscess
  • sepsis
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15
Q

What type of pain is usually present in peptic ulcer disease?

A

steady, well-localized epigastric pain

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16
Q

If there is perforation in a patient with peptic ulcer disease, how would they present and what pain occurs?

A
  • presents w/ rigid abdomen

- intense, steady pain

17
Q

Explain the distribution of pain in a patient with a kidney stone

A
  • severe flank pain

- radiates to groin (+ scrotum in males)

18
Q

What is cholecystitis?

A

inflammation of the gall bladder

19
Q

In a patient with cholecystitis, how would they present? (symptoms)

A
  • nausea
  • vomiting
  • RUQ pain
  • tenderness
  • fever
  • positive Murphy’s sign
20
Q

What is Murphy’s Sign and what is it associated with?

A

Positive Sign = sudden pausing during inspiration upon deep palpation of the RUQ due to pain

indicative of acute cholecystitis