wk 8 3 - acute abdomen Flashcards
what is an acute abdomen
progresive intra-abdominal condition (<10days)
-severe threat to life
common causes of acute abdomen
appendicitis intestinal obstruction urological causes gallstones diverticular disease trauma malignancy perforated ulcer pancreatitis IBS infections gynae things
symptoms of acute abdomen
ab pain - visceral/parietal/extra-abdominal- radiates? nausea/vomiting burping dyspepsia change in bowel habit PR - blood/mucus
vague pain that suddenly localises is a classic symptom of
appendicitis
coffee ground vomiting indicates
upper GI bleed
signs on examination
peritonism - localised general pertonitis (board like) guarding rebound tenderness rosvigs sign (appendicitis - palpation of LLQ increases pain felt in RLQ
auscultation
absent bowel sounds in ileus
outline treatment of acute abdomen
give analgesia (check allergies) - IV morphine - IV paracetamol anti-emetic O2 if hypoxic Fluids
cullens sign
bruisiing at flanks/peri-umbilical
indicates acute pancreatitis
intiial investigations of acute abdomen
bloods (FBC,LFT,UE,CRP,Ca,Lactate, Coag)
AMYLASE - pancreatitis
ABG
AXR
CXR - First line
CT - gold standard
Ultrasound if RUQ/RIF pain (useful in kids/women with pelvic pain)
CXR would rule out
pneumonia
AXR is useful if _____, ______ or ______ is indicates
colitis
perforation
obstruction
2 things which must be ruled out in acute abdomen presentation, why
pancreatitis
symptomatic AAA
will die
5 colonic emergencies
obstruction volvulus acute diverticulitis toxic colitis perforations - iatrogenic (due to surgery) stercoral (due to internal contents) or
management of a volvulus
decompress using rigid sigmoidoscope
