TH2 ACUTE ABDOMEN Flashcards
ACUTE ABDOMEN
SIGNS + SYMPS OF ABDOMINAL PAIN + TENDERNESS
CLINICAL PRESENTATION OFTEN REQUIRES EMERGENCY SURGICAL THERAPY
MOST COMMON SURGICAL ACUTE ABDOMINAL CONDITION PRESENTED WITH ACUTE ABDOMEN?
ABDO. ORGAN INFECTION ABDO. ORGAN ISCHEMIA INTRA ABDOMINAL HEMORRHAGE GASTRO INTESTINAL PERFORATION ILEUS
WHAT IS THE ORDER OF EXAMINATION FOR ACUTE ABDOMEN
HISTORY
PHYSICAL EXAMINATION
LAB TESTS
IMAGING STUDIES
MOST COMMON GENERAL SURGICAL EMERGENCY
ACUTE APPENDICITIS
ACUTE APPENDICITIS
ACUTE INFLAMMATORY PROCESS OF APPENDIX
POSITION OF APPENDIX IN RELATION TO CAECUM?
MEDIAL RETROCECAL LATEROCECAL SUBHEPATIC TIP CLOSE TO LEFT COLON PELVIC
HOW DOES HISTORY OF ACUTE APPENDICITIS BEGIN?
CENTRAL ABDOMINAL PAIN OF VISCERAL TYPE
ILL LOCALISED
> USUALLY AROUND UMBILICUS/ EPIGASTRIUM
MOST SENSITIVE SIGN OF ACUTE APPENDICITIS WITH LOCAL PERITONEAL IRRITATION
RIGHT LOWER ABDOMINAL QUADRANT PAIN
> SOMATIC PHASE OF PAIN
MOST COMMON ABDOMINAL PHYSICAL FINDING IN ACUTE APPENDICITIS?
LOCAL TENDERNESS
GUARDING IN RLQ
HALLMARK FOR DIAGNOSING ACUTE ABDOMEN
TENDERNESS OVER SITE OF APPENDIX
MANAGEMENT OF ACUTE APPENDICITIS
APPENDECTOMY
PERIAPPENDICULAR INFILTRATE
PERFORMATION OF APPENDIX > LEADING TO PERIAPPENDICULAR ABSCESS
> host defence reaction against spreading of inflammation from appendix into peritoneal cavity
WHY ACUTE APPENDICITIS IN OLDER PX CAN BE DIFFICULT TO DX?
PX DELAY SEEKING CARE + PRESENTATION MAY BE ATYPICAL
AGED GROUP OF PERIAPPENDICULAR INFILTRATE?
ELDERLY PX DUE TO LATE COURSE OF ACUTE APPENDICITIS
OTHER CONDITIONS CLINICALLY PRESENTED LIKE PERIAPPENDICULAR INFILTRATE?
CANCER OF CECUM ACCOMPANIED BY PERITUMOUR INFLAMMATION
PRESENTATION OF PERIAPPENDICULAR INFILTRATE ON PHYSICAL EXAMINATION?
MODERATE PAINFUL PALPABLE MASS IN RLQ
WHY IS DX OF APPENDICITIS IN PREGNANCY DIFFICULT?
APPENDIX DISPLACED BY GRAVID UTERUS + ABDOMINAL WALL LIFTED FROM APPENDIX BY GRAVID UTERUS
MECKELS DIVERTICULUM
true diverticulum of variable size derived from intestinal remnant of yolk stalk/ omphalomesenteric duct
LOCALISATION OF MECKELS DIVERTICULUM?
ANTIMESENTERIC BORDER OF TERMINAL ILEUM
APPROX. 40-50cm FROM ILEOCECAL VALVE IN ADULTS
COMPLICATION OF MECKELS DIVERITCULUM?
GI BLEEDING PERFORATION SMALL INTESTINE OBSTRUCTION DIVERTICULITIS ENTEROLITHS FOREIGN BODIES INTO DIVERTICULUM
CROHNS DISEASE
CHRONIC TRANSMURAL INFLAMMATORY DISEASE OF GIT
> UNKNOWN CAUSE
WHICH ALIMENTARY TRACT IS MOST COMMONLY INVOLVED IN CROHNS DISEASE?
SMALL INTESTINE +
COLON
STAGES OF CROHNS DISEASE?
ACUTE
- transmural abscess + perforation of intestinal wall
SUBACUTE
- granulomas + ulcers onto intestinal mucosa produced
CHRONIC
- fibrotic transformation of intestine wall
MOST COMMON CLINICAL PRESENTATION OF ACUTE STAGE OF CROHNS DISEASE?
ABDOMINAL PAIN
MELENA/ DIARRHOEA WITH BLOOD (mucosal ulcer)
