The acute abdomen

Question 1

definition of the acute abdomen

Answer 1

a combination of symptoms and signs, including abdominal pain, which results in a patient being referred for an urgent general surgical opinion

Question 2

aetiology of acute abdomen most common

Answer 2

non-specific pain (30-45%)

acute appendicitis (20-25%)

acute cholecystitis (7-8%)

peptic ulcer (4%)

urinary retention (4%)

Question 3

3 things to consider when looking at the pathophysiology of the acute abdomen

Answer 3

peritonitis

intestinal obstruction

abdominal pain

Question 4

routes of infection for peritonitis

Answer 4

perforation of GI/biliary tract

female genital tract

penetration of abdominal wall

haematogenous spread

Question 5

peritonitis

Answer 5

inflammation of the peritoneum

Question 6

generalised peritonitis represents failure of localisation and occurs when….?

Answer 6

contamination is too rapid

contamination persists

abscess ruptures

Question 7

cardinal features of intestinal obstructions

Answer 7

pain

vomiting

distension

constipation

borborygmi

Question 8

borborygmi

Answer 8

a rumbling or gurgling noise made by the movement of fluid and gas in the intestines

Question 9

different characters of abdominal pain

Answer 9

visceral

somatic

referred

Question 10

visceral pain receptors appear in the…

Answer 10

smooth muscle

Question 11

peritonitis and intestinal obstructions can lead to ……… which would lead to circulatory collapse and often death

Answer 11

fluid loss

sepsis

Question 12

investigations of the acute abdomen

Answer 12

urine test

labs (FBC, LFT, UandEs)

radiology

larproscopy

Question 13

acute abdomen resuscitation

Answer 13

restore circulation fluid volume

ensure tissue perfusion

enhance tissue oxygenation

treat sepsis

decompress gut

ensure adequate pain relief

Question 14

treatment of the acute abdomen

Answer 14

pain relief

antibiotics

definitive interventions (eg surgery)