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cp3 @ uon - medicine & surgery > The Acute Abdomen > Flashcards

The Acute Abdomen Flashcards

1
Q

What is The Acute Abdomen?

A

An emergency surgical condition caused by damage to one or more of the abdominal organs due to injury or disease’

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2
Q

What are the key types of pain the acute abdomen can present with?

A

Inflammatory
Obstructive
Referred visceral pain (typically midline)

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3
Q

Describe inflammatory pain

A

Constant pain w/ a raised temp, pulse and leucocytosis

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4
Q

What is Peritonitis?

A

Inflammation of peritoneum giving localised pain

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5
Q

Describe the pain present in Peritonitis

A

Localised pain (due to somatic innervation)
Exacerbated by movement, coughing, inspiration
Associated w/ guarding and rigidity

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6
Q

Describe the pain present in Obstruction

A

Colicky pain, agitates patients

Can become constant w/ superimposed inflammation

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7
Q

Describe referred pain from the foregut

A

Foregut (oesophagus - D2) pain is referred to the upper abdomen

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8
Q

Describe referred pain from the midgut

A

Midgut (D2 - transverse colon) pain is referred to the middle abdomen

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9
Q

Describe referred pain from the hindgut

A

Hindgut (transverse colon - rectum) is referred to the lower abdomen

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10
Q

What types of condition can cause a presentation of the acute abdomen?

A 
Abdominal viscera conditions
Vascular conditions
Medical conditions
Gynae conditions
Other conditions
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11
Q

What abdominal viscera conditions should be included in the acute abdomen ddx?

A 
Acute appendicitis
Meckel's diverticulitis
Intestinal obstruction
Perforated viscus (acute severe pain + shock)
Acute pancreatitis
Acute cholecystitis/cholangitis
Renal calculi
Acute scrotum
IBD
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12
Q

What vascular conditions should be included in the acute abdomen ddx?

A

AAA

Mesenteric thrombosis/embolus

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13
Q

What medical conditions should be included in the acute abdomen ddx?

A

GORD

Referred pain from pneumonia/MI/UTI/Pyelonephritis

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14
Q

What gynae conditions should be included in the acute abdomen ddx?

A

Ruptured ectopic pregnancy
Tortured/ruptured ovarian cysts
Salpingitis

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15
Q

What other conditions should be included in the acute abdomen ddx?

A

Non-specific mesenteric adenitis

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16
Q

What investigations are appropriate for a patient presenting with an acute abdomen?

A 
FBC, U&Es, LFTs, CRP, Amylase, ABG
Pregnancy test
Urinalysis
Erect CXR/AXR
USS/CT
17
Q

What is the appropriate initial management of an acute abdomen?

A

ABCDE resuscitation

Urgent laparotomy in certain conditions

18
Q

Which abdominal conditions require urgent laparotomy?

A

Organ rupture (spleen/aorta/ectopic)
Peritonitis (perforated ulcer, diverticulum, appendix, gallbladder)
Pancreatitis can mimic these

19
Q

What tests should always be done to check for pancreatitis?

A

Amylase

Lipase

cp3 @ uon - medicine & surgery (135 decks)

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