The Acute Abdomen

Question 1

Define the Acute Abdomen

Answer 1

Abdominal conditions that cause patients to be hospitalised within a few hours of the onset of their pain.

Question 2

Acute Abdomen differentials

Answer 2

Acute cholecystitis. Acute appendicitis or Meckel’s diverticulitis. Acute pancreatitis. Ectopic pregnancy. Diverticulitis. Peptic ulcer disease. Pelvic inflammatory disease. Intestinal obstruction Gastroenteritis. Acute intestinal ischaemia/infarction or vasculitis. Gastrointestinal (GI) haemorrhage. Renal colic or renal tract pain. Acute urinary retention. Abdominal aortic aneurysm. Testicular torsion.

Question 3

Identify the cardinal symptoms and describe the pain patterns

Answer 3

Colic pain (rolling around) or lying still (peritonitis), Signs of shock/sepsis (organ rupture) Fever, Distention & tinkling bowel sounds (obstruction) Sudden or gradual onset? Site of pain and where it radiates? Colic or continuous?

Question 4

Differential in relation to site of pain

Answer 4

Question 5

Investiagions

Answer 5

Bloods - All the bloods

Imaging - US, Xray (diaphragm air, distension), CT

Urine Dip - Pregnancy, Infection, Blood

Question 6

Management

Answer 6

Oxygen?

Nil by mouth

Abx?

IV fluids?

Analgesia?

NG tube?

Antiemetic?