Uploaded bySmruti Patanaik
Accute Abdomen
The document provides information about acute abdomen including potential causes, relevant history questions, physical exam findings, and management strategies. It discusses signs and symptoms of several specific conditions that can cause acute abdomen such as appendicitis, duodenal ulcer, kidney stones, abdominal aortic aneurysm, pancreatitis, cholecystitis, and bowel obstruction. The physical exam involves assessing vital signs, palpating the abdomen, and listening to bowel sounds while the management focuses on airway, nothing by mouth, and considering other potential causes like cardiac or gynecological issues.
More Related Content
Accute Abdomen
- 1. Acute Abdomen TempleCollege EMS Professions
- 2. Acute Abdomen Generalname for presence of signs, symptoms of inflammation of peritoneum (abdominal lining)
- 3. Acute Abdomen Determiningexact cause irrelevant in pre-hospital care Important factor is recognizing acute abdomen is present
- 4. History Where doyou hurt? Know locations of major organs But realize abdominal pain locations do not correlate well with source
- 5. History What doespain feel like? Steady pain - inflammatory process Crampy pain - obstructive process
- 6. History Was onsetof pain gradual or sudden? Sudden = perforation, hemorrhage, infarct Gradual = peritoneal irrigation, hollow organ distension
- 7. History Does painradiate (travel) anywhere? Right shoulder, angle of right scapula = gall bladder Around flank to groin = kidney, ureter
- 8. History Duration? >6 hour duration = ? surgical significance Nausea, vomiting? Bloody? “Coffee Grounds”? Any blood in GI tract = Emergency until proven otherwise
- 9. History Change inurinary habits? Urine appearance? Change in bowel habits? Appearance of bowel movements? Melena?
- 10. History Regardless ofunderlying cause vomiting or diarrhea can be a problem because of associated volume loss
- 11. History Females Lastmenstrual period? Abnormal bleeding? In females, abdominal pain = Gyn problem until proven otherwise
- 12. Physical Exam GeneralAppearance Lies perfectly still inflammation, peritonitis Restless, writhing obstruction Abdominal distension? Ecchymosis around umbilicus, flanks?
- 13. Physical Exam Vitalsigns Tachycardia ? Early shock (more important than BP) Rapid shallow breathing peritonitis Tilt test should be done with non-traumatic abdominal pain
- 14. Physical Exam Palpateeach quadrant Work toward area of pain Warm hands Patient on back, knee bent (if possible) Note tenderness, rigidity, involuntary guarding,voluntary guarding, masses
- 15. Physical Exam BowelSounds Listen 1 minute in each quadrant Listen before feeling Absent bowel sounds ileus, peritonitis, shock Auscultating bowel sounds has no pre-hospital value in trauma patients
- 16. Management Airway Highconcentration O 2 Anticipate vomiting Anticipate hypovolemia Nothing by mouth No analgesics, sedatives
- 17. Management In adults > 30 , consider possibility of referred cardiac pain . In females , consider possible gyn problem, especially tubal ectopic pregnancy
- 18. Appendicitis Usually dueto obstruction with fecalith Appendix becomes swollen, inflamed gangrene, possible perforation
- 19. Appendicitis Pain beginsperiumbilical; moves to RLQ Nausea, vomiting, anorexia Patient lies on side; right hip, knee flexed Pain may not localize to RLQ if appendix in odd location Sudden relief of pain = possible perforation
- 20. Duodenal Ulcer DiseaseSteady, well-localized epigastric pain “Burning”, “gnawing”, “aching” Increased by coffee, stress, spicy food, smoking Decreased by alkaline food, antacids
- 21. Duodenal Ulcer DiseaseMay cause massive GI bleed Perforation = intense, steady pain, pt lies still, rigid abdomen
- 22. Kidney Stone Mineraldeposits form in kidney, move to ureter Often associated with history of recent UTI Severe flank pain radiates to groin, scrotum Nausea, vomiting, hematuria Extreme restlessness
- 23. Abdominal Aortic AneurysmLocalized weakness of blood vessel wall with dilation (like bubble on tire) Pulsating mass in abdomen Can cause lower back pain Rupture shock, exsanguination
- 24. Pancreatitis Inflammation ofpancreas Triggered by ingestion of EtOH; large amounts of fatty foods Nausea, vomiting; abdominal tenderness; pain radiating from upper abdomen straight through to back Signs, symptoms of hypovolemic shock
- 25. Cholecystitis Inflammation ofgall bladder Commonly associated with gall stones More common in 30 to 50 year old females Nausea, vomiting; RUQ pain, tenderness; fever Attacks triggered by ingestion of fatty foods
- 26. Bowel Obstruction Blockageof inside of intestine Interrupts normal flow of contents Causes include adhesions, hernias, fecal impactions, tumors Crampy abdominal pain; nausea, vomiting (often of fecal matter); abdominal distension
- 27. Esophageal Varices Dilatedveins in lower part of esophagus Common in EtOH abusers, patients with liver disease Produce massive upper GI bleeds