The Acute Abdomen Flashcards
what is munchausen
factitious disease
what is rosvig’s sign?
palpation in LLQ increases pain in RLQ
= appendicitis
what can cause tinkling bowel sounds?
subacute bowel obstruction
what would be found on examination of peritonitis?
guarding “board like”
rebound tenderness
when might bowel sounds be absent?
intestinal obstruction
peritonitis
obese
paralytic ileus
what is usually given with strong analgesic?
anti-emetic
what is the initial management of acute abdomen?
ABC oxygen fluids observations urinalysis treat nausea/pain
what is cullens sign?
oedema and bruising around umbilicus
indicates severe acute pancreatitis
what is grey turner’s sign?
bruising of flank areas
indicates pancreatic problem
what is erythema ab igne?
“hot water bottle rash”
due to excess exposure to heat
what abdominal signs indicate that it is not an acute condition?
caput medusae
jaundice
striae
masses
what are the initial investigations for acute abdomen?
FBC (AMYLASE, CRP, LFTs, coagulase, lactate, Us&Es, Ca) AXR erect CXR CT = gold standard US good in RIF/RUQ pain, women and kids
what fatal conditions must be checked for and excluded to prevent death?
pancreatitis
AAA
what acute abdomen patients need immediate surgery?
faecal peritonitis
ischaemic gut
perforated duodenal ulcer
AAA?
what does “board like” guarding indicate
peritonitis
perforated duodenal ulcer
how is a perforated duodenal ulcer treated?
resuscitate antibiotics theatre if needed Patch repair eradicate H. Pylori and PPI
what conditions are classes as colonic emergencies?
obstruction volvulus acute diverticulitis toxic colitis perforations
how is a volvulus managed?
decompress using rigid sigmoidoscope
how is a malignant obstruction managed?
surgery or stent
how is diverticulitis managed?
ranges from antibiotics to hartmanns procedure
how is typhlitis managed?
antibiotics or operate
what is stercoral perforation and how is it managed?
breach of intestinal wall due to damage from internal contents
managed by removing colon
how is a leak/small perforation managed?
theatre
how is diverticulitis classified?
Hinchey classification
1 = paracolic abscess 2 = pelvic abscess 3 = purulent peritonitis 4 = faecal peritonitis
what is hartmann’s procedure?
removes sigmoid colon
leaves rectum
creates colostomy
used in diverticulitis
