Questions and Answers
What is an acute abdomen?
The acute onset of severe abdominal pain that requires urgent medical or surgical evaluation and intervention.
Which of the following are symptoms of an acute abdomen? (Select all that apply)
Abdominal pain can be of various characters such as colicky, constant, sharp, dull, burning, or stabbing.
True
What are some surgical causes of acute abdomen? (Select all that apply)
Signup and view all the answers
List two key investigations used in the management of acute abdomen.
Signup and view all the answers
What are red flags in acute abdomen? (Select all that apply)
Signup and view all the answers
In the case of acute abdomen, abdominal ____ can indicate peritonitis.
Signup and view all the answers
What is a common risk factor for mesenteric ischemia?
Signup and view all the answers
Guarding is a voluntary contraction of abdominal muscles upon palpation.
Signup and view all the answers
Match the causes of acute abdominal pain to their categories:
Signup and view all the answers
Study Notes
Acute Abdomen Definition
- Acute abdomen refers to a sudden and severe abdominal pain requiring urgent medical or surgical evaluation.
- Symptoms include persistent pain, tenderness, guarding, fever, vomiting, sweating, and altered vital signs.
Mechanisms of Abdominal Pain
- Inflammation of the parietal peritoneum produces steady, localized pain worsened by movement.
- Hollow viscus obstruction causes colicky pain, potentially leading to a steady state if distention occurs.
- Vascular disturbances result in sudden or gradual severe pain.
Referred Pain
- Referred pain from thorax, spine, or genitalia complicates diagnosis and can mimic acute surgical emergencies.
- Conditions such as pneumonia and pleurisy may present with abdominal pain and associated respiratory symptoms.
- ECG is crucial in high-risk patients to detect underlying cardiovascular issues.
Clinical Features
- Acute onset of pain can vary in character and severity, aiding localization and diagnosis.
- Accompanying symptoms may include nausea, vomiting, sweat, loss of appetite, fever, bloating, changes in bowel habits, and urinary symptoms.
Physical Examination Vital Signs
- Vital signs may show tachycardia (indicating pain, fever, hypovolemia), hypotension (fluid loss or septic shock), and tachypnea (response to pain or metabolic acidosis).
- Clinical signs of shock include pale skin, rapid pulse, low blood pressure, and altered mental status.
Abdominal Examination Findings
- Abdominal distension indicates gas or fluid accumulation.
- Tenderness, rebound tenderness, guarding, and rigidity suggest peritonitis.
- Bowel sounds may be absent (indicating ileus/peritonitis) or hyperactive (suggesting obstruction).
Underlying Pathologies
- Common causes include inflammation/infection, ischemia, hemorrhage, obstruction, and perforation of solid or hollow organs.
Surgical Causes of Acute Abdomen
- Perforated peptic ulcer presents with severe epigastric pain and peritonitis.
- Mesenteric ischemia leads to acute pain, particularly in elderly with cardiovascular disease.
- Appendicitis, cholecystitis, bowel obstruction, diverticulitis, ectopic pregnancy, AAA leak/rupture, hernias, trauma, volvulus, and intussusception are major surgical concerns.
Investigations
- Initial tests include FBC, CRP, electrolytes, amylase, and liver function tests.
- Imaging: erect CXR, supine abdominal X-ray, USS, and CT scans are key diagnostic tools.
Acute Visceral Perforation
- Involves any bowel segment; requires urgent intervention upon presentation of localized or generalized peritonitis.
Ureteric Colic
- Common cause for surgical missions, characterized by loin-to-groin pain and possible hematuria.
Leaking Aortic Aneurysm
- Typically occurs in the elderly with cardiovascular risk factors; presents with severe abdominal/back pain and hemodynamic instability.
Causes of Acute Abdominal Pain - Medical/Non-Surgical
- Include metabolic disorders (DKA, Addison disease), cardiovascular issues (MI, PE), infections (viral hepatitis), toxins, hematological/immunological disorders, neuropsychiatric conditions, renal issues, and gynecological concerns.
Acute Mesenteric Ischemia
- Types include embolic, thrombotic, and non-occlusive, with risk factors such as dysrhythmias and atherosclerotic diseases.
Management of Acute Abdomen
- Initial management includes assessment, hydration, analgesia, and preparatory steps for surgical interventions if required.
Red Flags in Acute Abdomen
- Severe pain, signs of shock, peritonitis signs (guarding or rigidity), and abdominal distention warrant immediate attention.
Further Management Strategies
- Depend on the underlying pathology, severity of the condition, patient’s presentation, and comorbidities to decide on medical or surgical interventions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers the definition and mechanisms of abdominal pain, particularly focusing on acute abdomen. You will explore symptoms, types of pain, and underlying causes that necessitate urgent medical evaluation.
