The acute abdomen Flashcards
clinical syndromes that require laparotomy
rupture of an organ, peritonitis
syndromes that may not require laparotomy
local peritonitis, colic
what is peritonitis
perforation of peptic ulcer/duodenal ulcer, diverticulum, appendix, bowel, gallbladder
signs peritonitis
prostration, shock,lying still, +ve cough test, tenderness, board like abdominal rigidity, guarding, no bowel sounds
what may a CXR show in peritonitis
gas under the diaphragm
what are examples of local peritonitis
diverticulitis, cholecystitis, salpingitis, appendicitis
when would abscess formation be suspected
swelling, swinging fever, incr WCC (do ultrasound or CT guided)
what can local peritoneal inflammation cause
localised ileus with a ‘sentinel loop’ of intraluminal gas on plain AXR.
what is ileus
disruption of the normal propulsive ability of the GI tract
how does colic present differently to peritonitis
causes restlessness
what is colic caused by
muscular spasm in a hollow viscus eg gut, ureter, salpinx, uterus, bile duct, gallbladder
what tests are done
U&E, FBC, LFT, CRP, ABG (mesenteric ischaemia), urinalysis. Erect CXR, AXR, CT, USS- perforation or free fluid.
what is the chief cause of the acute abdomen
IBS
other causes acute abdomen
MI, gastroenteritis, UTI, DM, DKA, pneumococcal pneumonitis, pneumonia, TB, porphyria, PAN, malaria, cholera etc
plan for acute abdomen
treat shock, cross match, blood culture, antibios, relieve pain, IVI, abdo film, CXR, ECG, consent, NBM
