The Acute Abdomen

Question 1

what is the acute abdomen

Answer 1

a combinatin of signs and symptoms, most notably pain, which result in a patient being referred for an urgent surgical opinion

Question 2

distribution of top 6 acute abdomen causes

Answer 2

non-specific pain - 30-45% 
acute appendicitis - 20-25%
acute cholecystitis/colic - 7-8%
peptic ulcer perforation - 4%
urinary retention - 4%
small bowel obstruction - 3%

Question 3

which layer of the peritoneum has more localised pain sensation

Answer 3

parietal

Question 4

routes through which the peritoneum can become infected

Answer 4

perforation of GI tract
female genital tract
penetration of abdominal wall
haematogenous

Question 5

change in bacteria through peritonitis

Answer 5

aerobe population declines as anaerobe population climbs

Question 6

what would a ruptured abscess to do the localisation of pain in peritonitis

Answer 6

generalise it

Question 7

features of visceral pain

Answer 7

poorly localised, runs along with associated blood supply

Question 8

what is somatic and referred pain

Answer 8

pain from receptors in parietal peritoneum or abdominal wall that can be referred by the integration of nerves

Question 9

consequence of peritonitis

Answer 9

sepsis and fluid loss

Question 10

how would you manage acute abdomen

Answer 10

ABCDE
restore fluids
maintain O2 sats
treat sepsis/remove gut obstruction
analgesia
surgery