L27: Acute Abdomen Flashcards
What is an acute abdomen?
- inflammation of peritoneum
- present for < 24 hours
- require emergency treatment
If a patient has STEADY abdominal pain, what is this suggestive of?
inflammatory process
- usually worsened by movement or coughing
If a patient has CRAMPY/COLICKY abdominal pain, what is this suggestive of?
obstructive process
If the abdominal pain is SUDDEN, what is this suggestive of?
perforation, harmorrhage or infarct…
If the abdominal pain is GRADUAL, what is this suggestive of?
peritoneal irritation, hollow organ distension…
If abdominal pain radiates to the right shoulder, what organ is most likely affected?
Gall Bladder
If abdominal pain radiates to around the flank to groin area, what organs/structures are most likely affected?
Kidney or Ureter
If abdominal pain radiates to the back, what are the 3 possible causes?
- AAA*
- Peptic Ulcer Disease
- Pancreatitis
An appendicitis usually occurs due to obstruction by a….
faecolith - stone made of faeces
Why might an appendix become gangrenous?
due to obliteration of appendix artery (during appendicitis)
Explain the distribution of pain in appendicitis
early = periumbilical pain later = moves to RLQ
If there is a sudden relief of pain in a patient with appendicitis, what does this indicate?
possible perforation
List the 6 positions that the appendix may be found in. Which is the most common?
- Retrocaecal - most common
- Paracaecal
- Subcaecal
- Preileal
- Postileal
- Pelvic
List some of the possible complications of acute appendicitis
- perforation
- RIF abscess
- adhesions
- pelvic abscess
- sepsis
What type of pain is usually present in peptic ulcer disease?
steady, well-localized epigastric pain
If there is perforation in a patient with peptic ulcer disease, how would they present and what pain occurs?
- presents w/ rigid abdomen
- intense, steady pain
Explain the distribution of pain in a patient with a kidney stone
- severe flank pain
- radiates to groin (+ scrotum in males)
What is cholecystitis?
inflammation of the gall bladder
In a patient with cholecystitis, how would they present? (symptoms)
- nausea
- vomiting
- RUQ pain
- tenderness
- fever
- positive Murphy’s sign
What is Murphy’s Sign and what is it associated with?
Positive Sign = sudden pausing during inspiration upon deep palpation of the RUQ due to pain
indicative of acute cholecystitis
