The Acute Abdomen Flashcards
What are the causes of acute abdomen?
Non-specific pain Acute appendicitis Acute cholecystitis/colic Peptic ulcer perforation Urinary retention Acute pancreatitis Small bowel obstruction Trauma Urinary stones Large bowel obstruction Acute diverticulitis Malignancy Medical disorders Vascular conditions Gynaecological conditions
What are the routes of infection for peritonitis?
Perforation of GI/biliary tract
Female genital tract
Penetration of abdominal wall
Haematogenous spread
When does generalised peritonitis occur?
When contamination too rapid, contamination persists or abscess ruptures
What are the cardinal features of intestinal obstruction?
Pain Vomiting Distension Constipation Borborygmi
What are the different characters of abdominal pain?
Visceral
Somatic
Referred
What is visceral pain?
Pain receptors in smooth muscle
Afferent impulses run with sympathetic fibres accompanying segmental vessels (CP, SMA, IMA)
What is somatic and referred pain?
Receptors in parietal peritoneum or abdominal wall
Afferent signals pass with segmental nerves
What are the effects of peritonitis, ischaemia and obstruction?
Fluid loss and sepsis can lead to circulatory collapse and can lead to death
What is the management process of acute abdomen?
Assess (+ resuscitate)
Investigate
Observe
Treat
What investigations are done for acute abdomen?
Urine + bHCG FBC, U+Es, LFTs, amylase USS CT Laparoscopy vs laparotomy
What is the resuscitation process of acute abdomen?
Restore circulating fluid volume Ensure tissue perfusion Enhance tissue oxygenation Treat sepsis Decompress gut Ensure adequate pain relief
What is the treatment for acute abdomen?
Pain relief
Antibiotics
Definitive interventions (e.g. surgery)
