The Acute Abdomen Flashcards Preview

07. Year 2: Alimentary System > The Acute Abdomen > Flashcards

Flashcards in The Acute Abdomen Deck (27)
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1

What is acute abdomen?

A combination of symptoms and signs including abdominal pain, which results in the patient being referred for an urgen general surgical opinion

2

What is the aetiology of acute abdomen?

Non-specific pain

Acute appendicitis

Acute cholecystitis

Peptic ulcer perforation

Urinary retention

3

What should be considered for the pathophysiology of acute abdomen?

Peritonitis

Intestinal obsruction

Abdominal pain

4

What is the surface area of the peritoneum?

About 2m2

5

What activity is done by the peritoneum?

Fibrinolyric (blood clotting)

6

What are the 2 layers of the peritoneum?

Parietal and visceral

7

What is peritonitis?

Infections of the peritoneum

8

What are some routes of infection for peritonitis?

Perforation of GI/biliary tract

Female genital tract

Penetration of the abdominal wall

Haematogenous spread

9

Are anaerobes or aerobes more likely to cause diffuse pritonitis?

Aerobes

10

Are anaerobes or aerobes more likely to cause abscess?

Anaerobes

11

What are the 2 vague kinds of peritonitis?

Localsied or generalised

12

When does generalised peritonitis occur?

Contamination too rapid

Contamination persists

Abscess ruptures

13

What are cardinal features of intestine obstruction?

Pain

Vomiting

Distension

Constipation

Borborygmi

14

What do symptoms of obstruction depend on?

Site (proximal vs distal)

15

What abdominal pain, what must be asked?

Character of pain

Site of pain

Severity of pain

Systemic upset

16

What receptors are responsible for visceral pain?

Pain receptors in smooth muscles

17

Where does afferent impulses of viseral pain run?

With sympathetic fibres accompanying segmental vessels

18

Is visceral pain well or poorly localised?

Poorly localised

19

What receptors are responsible for somatic and reffered pain?

Receptors in parietal peritoneum or abdominal wall

20

What do afferent signals of somatic and referred pain travel with?

With segmental nerves

21

Is the localisation of somatic and refered pain good or bad?

Accurate localisation

22

What are the clinical consequences of peritonitis and intestinal obstruction?

Causes fluid loss and sepsis

Then circulatory collapse

Then death

23

What are the steps for managing acute abdomen?

1) Assess (and resuscitate if required)

2) Investigate

3) Observe

4) Treat

24

What is required for the assessment of acute abdomen?

History

Examination

Investigation

25

What investigations can be done for acute abdomen?

Ward tests (urine)

Lab tests (FBC, U&E, LFT)

Radiology (plain, US, axial CT)

Laparoscopy vs laparotomy

26

What steps are involved in resuscitation for acute abdomen?

Restore circulating fluid volume

Ensure tissue perfusion

Enhance tissue oxygenation

Treat sepsis

Decompress gut

Ensure adequate pain relief

27

What is the treatment for acute abdomen?

Pain relief

Antibiotics

Definitive interventions such as surgery