The acute abdomen Flashcards
What is the acute abdomen
series of signs and symptoms (including abdominal pain) which lead to referral for urgent general opinion
Causes of acute abdomen
-Non-specific pain
acute appendicitis
-acute cholecystitis
-peptic ulcer perforation
Differential diagnosis of acute abdomen
Peritonitis
Intestinal obstruction
Pathology of peritonitis?
- Decreased fibrolytic activity
- Increased fibrous tissue
- Peritoneum becomes adhered to organs and walls
Routes of infection of peritonitis?
- Female genital tract
- Perforation of GI/Bile duct
- Penetration of abdominal wall
- Hematogenous spread i.e. blood
What happens to bacterial flora in peritonitis?
-Number of anaerobes increases
-Number of aerobes decreases (after 5 days)
More severe in abcess than diffuse peritonitis
Differences between generalised and localised,lised peritonitis?
Generalised occurs when the body fails to localise the problem:
- Contamination is too rapid
- Contamination persists
- Abcess ruptures
What happens when abceses rupture in Peritonitis
Loss of fluid
Potential sepsis
Types of intestinal obstruction
- Something inside bowel
- Something adherent to bowel wall
- Something outside bowel wall
Symptoms of bowel obstruction
- Pain
- Vomiting
- Distension
- Constipation
- Borborygmi
What is Borborygmi?
Rubling/gurgling sound related to the movement of fluid
Proximal intestinal obstruction vs distal?
Proximal: vomiting/dehydration will occur before any other symptoms
Treatment
- monitor fluids
- analgesia
- Blood test + imaging
- Surgery/stenting
What is colic?
Pain that starts and stop abruptly .
Occurs due to muscular contractions in a hollow tube to relieve and obstruction a by forcing out the contents
Difference between visceral and somatic pain
Visceral:
- due to internal organs
- Associated with systemic illness
Somatic:
- Pain due to body wall
- Not associated with systemic illness
