Acute Abdomen Summary PDF

ACUTE ABDOMEN SUMMARY Acute abdomen refers to the sudden onset of severe abdominal pain that may require urgent medical or surgical intervention. Types 1. Inflammatory: Conditions like appendicitis, cholecystitis, and pancreatitis. 2. Obstructive: Bowel obstructions, volvulus, and intussusce...

ACUTE ABDOMEN SUMMARY Acute abdomen refers to the sudden onset of severe abdominal pain that may require urgent medical or surgical intervention. Types 1. Inflammatory: Conditions like appendicitis, cholecystitis, and pancreatitis. 2. Obstructive: Bowel obstructions, volvulus, and intussusception. 3. Vascular: Mesenteric ischemia, ruptured abdominal aortic aneurysm. 4. Perforative: Perforated peptic ulcer, perforated diverticulitis. 5. Traumatic: Blunt or penetrating abdominal trauma. Causes Inflammation: Appendicitis, diverticulitis, pancreatitis. Infection: Peritonitis, pelvic inflammatory disease. Obstruction: Bowel obstruction, gallstones. Ischemia: Mesenteric ischemia, strangulated hernia. Perforation: Perforated ulcer, perforated diverticulum. Trauma: Blunt or penetrating injuries. Signs and Symptoms Severe Abdominal Pain: Sudden and intense. Nausea and Vomiting: Often accompanies the pain. Abdominal Distension: Swelling of the abdomen. Fever: May indicate infection. Shock: Low blood pressure, rapid heart rate, sweating. Complications Sepsis: Infection spreading throughout the body. Peritonitis: Inflammation of the peritoneum. Organ Failure: Due to severe infection or shock. Death: If not treated promptly. Presentation Patients typically present with sudden, severe abdominal pain, often accompanied by nausea, vomiting, and signs of shock. Focused History and Physical Examination History: Onset, location, and character of pain, associated symptoms, past medical history, medications, and recent trauma.  Examination: Abdominal tenderness, guarding, rigidity, distension, and abnormal bowel sounds. Differential Diagnosis Gastrointestinal: Appendicitis, bowel obstruction, perforated ulcer. Hepatobiliary: Cholecystitis, pancreatitis. Urological: Renal colic, testicular torsion. Gynecological: Ectopic pregnancy, ovarian torsion. Vascular: Mesenteric ischemia, ruptured aneurysm. Investigations Laboratory Tests: Complete blood count, electrolytes, liver function tests, amylase/lipase, lactate. Imaging: Abdominal X-ray, ultrasound, CT scan. Electrophysiologic Tests: ECG if cardiac cause is suspected. Diagnostic Interventions: Diagnostic laparoscopy if needed. Treatment Non-Pharmacological Admission: Hospitalization for monitoring and treatment. Triage: Prioritizing care based on severity. Referral: To specialists if needed. Positioning: Elevating the head of the bed. Reassurance and Education: Informing the patient about their condition and treatment plan. Pharmacological IV Fluids: To maintain hydration and electrolyte balance. Oxygen: If indicated by respiratory distress. IV Antibiotics: To prevent or treat infection. Surgical Intervention Urethral Catheterization: To monitor urine output. Nasogastric Tube: To decompress the stomach. Operative Surgery: ○ Procedure: Depending on the cause, may involve appendectomy, cholecystectomy, or bowel resection. ○ Preoperative Preparation: Ensuring the patient is stable for surgery.  ○ Complications: Acute (infection, bleeding) and long-term (adhesions, recurrence). Multidisciplinary Team Involves surgeons, gastroenterologists, radiologists, anesthesiologists, and nursing staff. Monitoring and Evaluation Vital Signs: Regular monitoring of heart rate, blood pressure, and temperature. Treatment Efficacy: Assessing relief of symptoms and resolution of the underlying cause. Side Effects: Monitoring for adverse reactions to treatments. Patient Disposition To Theater: For surgical intervention if needed. Referral: To specialists for further management.