September 24, 2015 - Acute Abdomen II Flashcards

1
Q

Signs and Symptoms of Acute Abdomen

A

Abdominal pain

Distension

Nausea / vomitting

Constipation / obstipation

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2
Q

Obstipation

A

Severe or complete constipation caused by obstruction.

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3
Q

Proximal SBO Symptoms

A

Proximal small bowel obstruction

  • Vomitting is early and profuse
  • Rapid dehydration
  • Distension is minimal and not many fluid levels on imaging.
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4
Q

Distal SBO Symptoms

A

Distal small bowel obstruction

  • Vomitting is often delayed
  • Pain and central distension
  • Multiple air/fluid levels on imaging
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5
Q

LBO Symptoms

A

Large bowel obstruction

  • Distension is early and pronounced
  • Pain is less severe
  • Vomitting and dehydration occur later
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6
Q

Pathophysiology of Bowel Obstruction

A

Distension causes decreased absorption, and then increased secretion.

Increased intraluminal pressure.

Compresison of venules, bowel wall edema, decreased inflow from capillaries, and ischemia.

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7
Q

Types of Mechanical Obstruction

A
  1. Intraluminal
  2. Intrinsic bowel lesions
  3. Lesions extrinsic to the bowel
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8
Q

Intraluminal Causes of Obstruction

A
  1. Intussusception (the inversion of one portion of the intestine within another)
  2. Gallstone ileus (gallstone gets lodged in the small intestine)
  3. Bezoars
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9
Q

Intrinsic Bowel Lesions of Obstruction

A
  1. Congenital
  2. Neoplastic
  3. Inflammatory
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10
Q

Extrinsic Causes of Obstruction

A

1. Adhesions (scar tissue)

  1. Hernias
  2. Volvulas (twisting of stomach or intestine)
  3. Neoplasms
  4. Abscess
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11
Q

Management for Complete Obstruction

A

Early surgery. Usually 12-24 hours be in surgery because of the high risk of strangulation (20-40%).

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12
Q

Management for Partial Obstruction

A

Much lower risk of strangulation, and many will resolve without operative intervention. These can wait and follow with observation.

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13
Q

Absolute Indication for Surgery

A

Peritonitis

Free air

Irreducible hernia

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14
Q

Mesenteric Thrombosis

A

Progressive development of severe central abdominal pain.

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15
Q
A
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