The Acute Abdomen Flashcards
what is the acute abdomen?
signs and symptoms including abdominal pain which requires urgent referral to general surgery for opinion
what are the 3 main causes of the acute abdomen?
peritonitis
bowel obstruction
abdominal pain
what is the bacteriology of the gut?
from upper GI to lower GI it goes from colonised only by aerobes to mostly anaerobes with some aerobes in the lower GI
why is the bacteriology of the gut important?
need to tailor antibiotic treatment for infection
how does peritonitis cause pain?
infection results in the peritoneum stop producing fluid so the 2 layers stick together
what are the features of a typical patient with peritonitis?
severe abdominal pain made worse when leaning back patient leans forward stay still rigid abdomen, board like no bowel sounds guarding positive cough test
what are the routes of infection for peritonitis?
female genital tract
perforation of GI/ biliary tract
haemotgenous spread
penetration of abdominal wall
what is generalised peritonitis?
failure of the peritoneum to localise the infection
when does generalised peritonitis occur?
when the contamination is too rapid
contamination persists
abscess ruptures
what are the cardinal features of bowel obstruction?
abdominal pain vomitting distension consitipation borborygmi
what is the name for bowel obstruction pain and how does it occur?
colic pain
caused by smooth muscle contraction without being able to shorten due to the obstruction
what is the protocol for acute abdomen resuscitation ?
restore fluids pain relief ensure tissue perfusion and oxygenation treat sepsis decompress gut
what is the treatment for the acute abdomen?
antibiotics
surgery
analgesia
what are the most common causes of localised peritonitis?
inflammatory conditions of the gut i.e.;
- cholecystitis
- appendicitis
- diverticulitis
what causes generalised peritonitis?
irritation from leakage of intestinal contents i.e. perforated ulcer
