The Acute Abdomen Flashcards
definition of the acute abdomen
a combination of symptoms and signs, including abdominal pain.
most president things to consider with regards to the acute abdomen
- peritonitis
- intestinal obstruction
- abdominal pain
borborygmi
stomach rumble
different charcacters of abdominal pain
- visceral
- somatic
- referred
important things to consider with regards to abdominal pain
- character
- site
- severity
- systemic upset
visceral stomach pain
poorly localised pain coming from pain receptors in smooth muscle of gut
somatic gut pain
receptors in parietal peritoneum or abdominal wall
accurate localisation but can be in the wrong place (referred)
referred pain
pain can be accurately localised but from the ‘wrong place’ e.g. diaphragmatic pain would be felt in the shoulder cause thats where the nerve supply also goes
how might a patient with peritonitic pain behave as you approach them
apprehensive behaviour, guarding their stomach
pain gets better sitting forwards
how might a patient with body wall pain behave as you approach them
sitting forwards pain gets worse
3 routes of acute abdomen assessment after seeing GP
- home (saftey netting)
- walk in/ ambulatory clinic
- hospital admission
Acute Abdomen - basic management pathway
- assess (+abdominal resuscitation)
- investigate
- observe
- treat
U+E
urea and electrolytes
LFT
liver function test
what is involved in acute abdomen resuscitation
restore circulating fluid volume
ensure tissue perfusion
enhance tissue oxygenation
treat sepsis
decompress gut
ensure adequate pain relief
