The Acute Abdomen 1 Flashcards
Common diagnoses?
Acute cholecystitis
Perforated peptic ulcer
Appendicitis
Diverticulitis
Add pic of quadrants and organs
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Investigation?
Blood = FBC, U&E, LFT, amylase
Urine = dipstick for nitrite, blood protein, WCC
X-ray= erect chest, abdomen
Causes of acute abdominal pain?
Gastritis Biliary colic Gastroenteritis Inflammatory bowel disease Non specific abdominal pain
Acute cholecystitis?
Pyrexia, tachycardia, RUQ peritonitis
Murphy’s sign?
Positive for cholecystitis
Negative for choledocholithiasis, pyelonephritis, ascending cholangitis
Differential diagnosis for RUQ pain
Duodenal ulcer Biliary colic Hepatitis Right basal pneumonia NSAP
Perforated peptic ulcer?
Shock
Fever
Tachycardia
Rigidity + guarding
Diff diagnosis for peptic ulcer?
Pancreatitis
Gastritis
Cholecystitis
Leaking aortic aneurysm
Perforated peptic ulcer management
Resuscitation
-oxygen, iv, ng tube, antibiotics, analgesia
Emergency surgery
-laparotomy & repair
H pylori eradication
Appendicitis signs
Nausea, vomiting, RIF pain, anorexia
Pyrexic, tachycardia, foetor, RIF peritonitis (mcburney’s point) rovsings sign, PR tenderness
Diff diagnosis for appendicitis
Uti Mesenteric adenitis Ovarian Cust Pid/tuboovarian abscess Crohns Nsap(non specific abdo pain)
Investigations
Urine - negative dipstick
Blood - raised WCc in 90%
Ultrasound
Lap
Appendicitis management
Iv
Analgesia
Appendicectomy