The Acute Abdomen Flashcards
If a women of childbearing age presents with abdominal pain, what is one thing that should be considered?
Ectopic pregnancy
What are some of the routes of infection to the peritoneum which can lead to peritonitis?
Perforation of GI/biliary tree
Female genital tract
Perforation of abdominal wall
Haematogenous spread
Which part of the body is the only area in which the peritoneum is in contact with the external environment?
Female genital tract, hence why infection can spread via this
If there are more anaerobes than aerobes, what might happen?
Abscess formation
If there are more aerobes than anaerobes, what might happen?
Diffuse peritonitis
When may localised peritonitis become generalised peritonitis?
-If contamination is too rapid
-If contamination persists
-If abscess ruptures
What are some of the signs of intestinal obstruction?
Pain
Vomiting
Distension
Constipation
Borborygmi (rumbling/gurgling noise made by intestines).
Which part of the peritoneum is sensitive to pain?
Parietal peritoneum
How is visceral peritoneum sensitive to pain?
Pain receptors in the smooth muscle
Does visceral pain move or stay in one place?
Moves, despite inflammation often staying in one place
What can peritonitis or intestine obstruction lead to?
Fluid loss or sepsis, leading to circulatory collapse which could potentially cause death
What are the three things to give someone with sepsis?
Oxygen
Fluids
Antibiotics
What are the three things you should take from someone with sepsis?
Lactate
Blood culture
Measure urine output
What are some of the investigations that should be carried out to do with the acute abdomen?
-Urine
-Labs; WBC, LFT, U&E
-Radiology; plain, axial, ultrasound
-Laparoscopy
Why would urine tests be taken when looking at the acute abdomen?
Look for water infection
Rule out pregnancy
