Unit 3: Acute Abdomen Flashcards
What is Acute Abdomen?
sudden abdominal pain
-it is not a specific disease process
Initial Presentation of Acute Abdomen
- sudden onset of abdominal pain
- nausea/vomiting
> where the pain is located can rule in or out certain causes
Pain by Region
> Epigastric
- Gastritis
- Ulcers
> RUQ:
- gallbladder
- hepatic abscess
- duodenal ulcer
> LUQ:
- ulcers
- pancreatitis
- spleen
> LLQ:
- Diverticulitis
- Inflammatory bowel
> RLQ
- appendicitis
- inflammatory bowel
Duodenal Ulcer
- chronic
- located in RUQ
- pain resolves when eating
- affects the proximal part of the small intestine
- characterized by remissions and exacerbations (w/ complications that necessitate surgery)
Gastric Ulcer
- chronic
- epigastric pain
- pain gets worse when you eat
- occur in the lesser curvature of the stomach, near the pylorus
Treatment for Epigastric pain
supportive to decrease discomfort
- Histamine receptor antagonist (H2 blockers)
- Proton Pump Inhibitors
- Antacids
- GI protectant
- Anti-infective combinations
- Change diet
Histamine Receptor antagonists (H2 Blockers)
decrease gastric acid production
-short acting
Proton Pump Inhibitors
decrease gastric acid production
-long acting
Antacids
increase gastric pH
GI Protectants
provides a physical barrier
Anti-infective combinations
for the H. pylori
Peptic Ulcers
-Duodenal ulcer
-Gastric Ulcer
>risk factor: H. pylori infection
Complications of Acute Abdomen/ Peptic ulcers
- GI Bleed
- Penetration
- Perforation
- Obstruction
Complications: GI Bleed
- may be sudden, severe, and w/o warning
- symptoms of pain may not be present (common w/ NSAID use)
- acute hemorrhage: sudden weakness; dizziness; cold moist skin; passage of loose, tarry stools and coffee-ground emesis
- circulatory shock may develop depending on amount of blood loss
Complications: Penetration
- ulcer crater penetrates through adjacent organs; small bowel, pancreas, liver, or biliary tree
- referred pain to sites other than the abdomen, intense and persistent
- gradual increase in pain severity and frequency
