Acute abdominal pain of less than 1 weeks duration which has not - - PowerPoint PPT Presentation

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acute abdominal pain of less than 1 weeks duration which
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Acute abdominal pain of less than 1 weeks duration which has not - - PowerPoint PPT Presentation

Jan 23, 2024 317 likes •789 views

Acute abdominal pain of less than 1 weeks duration which has not been previously investigated of treated Rapid onset of severe symptoms that may indicate life-threatening intra-abdominal pathology sudden, severe abdominal pain of

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Acute abdominal pain of less than 1 weeks duration

which has not been previously investigated of treated

Rapid onset of severe symptoms that may indicate

life-threatening intra-abdominal pathology

sudden, severe abdominal pain of unclear etiology

that is less than 24 hours in duration.

pain in the abdomen that usually comes on suddenly

and is so severe that one may have to go to the hospital.

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ACUTE APPENDICITIS ACUTE CHOLECYSTITIS ACUTE PANCREATITIS ACUTE DIVERTICULITIS ACUTE SMALL BOWEL OBSTRUCTION ACUTE LARGE BOWEL OBSTRUCTION PERFORATED PEPTIC ULCER ACUTE URINARY TRACT INFECTION GYNAECOLOGICAL CAUSES GASTROENTERITIS

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RUPTURED AAA MESENTERIC ISCHAEMIA EXACERBATION OF PEPTIC ULCER INFLAMMATORY BOWEL DISEASE PNEUMONIA MEDICAL CONDITIONS MISCELLANEOUS CAUSES

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CAREFUL AND A DETAILED HISTORY THOROUGH CLINICAL EXAMINATION RELEVANT INVESTIGATIONS

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SITE MODE OF ONSET SEVERITY CHARACTER DURATION RADIATION AGGRAVATING FACTORS RELIEVING FACTORS ACCOMPANIMENTS

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THE AREAS OF THE ABDOMINAL WALL

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SUDDEN

  • PERFORATION

VASCULAR ACCIDENT OTHER MECHANICAL EVENT Eg. Volvulus

INSIDIOUS

INFLAMMATORY SLOW LEAKS SYMPTOMS FROM ADHESIONAL OBSTRUCTION

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PERFORATED PEPTIC ULCER PANCREATITIS BILIARY COLIC PERFORATED DIVERTICULITIS MESENTERIC ISCHAEMIA RUPTURED AAA URETERIC COLIC TWISTED OVARIAN CYST

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COLICKY

  • SMALL BOWEL OBSTRUCTION
  • LARGE BOWEL OBSTRUCTION
  • BILIARY OBSTRUCTION
  • URETERIC OBSTRUCTION
  • M ESENTERIC VASCULAR OCCLUSION

CONSTANT

  • PERITONEAL INFLAMMATION (PERITONITIS)
  • PERITONEAL IRRITATION (INTRAPERITONEAL BLEEDING)

THROBBING ORGAN FULL OF PUS LIKE OBSTRUCTIVE

APPENDICITIS AND EMPYAEMA OF GALL BLADDER

STABBING RUPTURED AORTIC ANEURYSM

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EPIGASTRIUM TO BACK------------PANCREATITIS EPIGASTRIUM TO BACK, UNDER THE COSTAL

MARGINS AND IN TO THE CHEST—BILIARY COLIC

HIGH LOIN TO UPPER ABDOMEN—RENAL COLIC LOIN TO GROIN ----URETERIC COLIC LOIN TO GROIN----- OVARIAN PATHOLOGY

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MOVEMENT--- PERITONITIS COUGHING----PERITONITIS MEALS-----EXACERBATION OF GASTRIC ULCER LYING FLAT----PANCREATITIS STRAIGHTENING THE HIPS—LOWER AB

PERITONITIS

HEAD LOW CAUSING SHOULDER TIP PAIN---

BLOOD IN THE PERITONEAL CAVITY EG. RUPTURED ECTOPIC

MICTURITION---INFLAMMED APPENDIX ON

BLADDER, TWISTED OV CYST

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LYING STILL PERITONITIS KEEPING HIPS BENT PELVIC PERITONTIS LEANING FORWARDS PANCREATITIS PASSING FLATUS OR FAECES – COLONIC

OBSTRUCTION

VOMITING----SMALL BOWEL

OBSTRUCTION,GASTRIC ULCER

MEALS ----EXACERBATION OF DUODENAL ULCER

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GENERAL ABDOMINAL RECTAL VAGINAL OTHER SYSTEMS

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Does the patient look ill? Is the patient lying comfortably in bed? Is the patient in pain? Is the patient finding it difficult to breathe? Is the pt tachypnoec? Is the patient tachycardic? Does the patient look pale? Is the patient jaundiced?

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  • MOVEMENT WITH RESPIRATION
  • DISTENSION
  • VISIBLE PERISTALSIS
  • TENDERNESS
  • GUARDING
  • RIGIDITY
  • REBOUND TENDERNESS
  • OBLITERATION OF LIVER DULLNESS
  • QUALITY OF PERISTALSIS
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CULLEN’S SIGN GRAY-TURNER SIGN ROVSING’S SIGN MURPHY’S SIGN PSOAS SIGN OBTURATOR SIGN

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FBC C REACTIVE PROTEIN LEVEL UREA AND ELECTROLYTES URINE DIPSTICK TEST SERUM AMYLASE LIVER FUNCTION TESTS URINE PREGNANCY TEST X-RAY CHEST ERECT X-RAY ABDOMEN ARTERIAL BLOOD GASES USS AND CT SCANNING

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  • THE PATIENT NEEDS IMMEDIATE SURGERY

THE PATIENT DOES NOT NEED IMMEDIATE

SURGERY

NEED FOR URGENT SURGICAL

INTERVENTION UNCERTAIN

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NG TUBE IV FLUIDS CATHETER ANALGESIA ANTIBIOTICS? GROUP AND SAVE LIAISE WITH ITU REGISTRAR CONSENT AND BOOK THEATRE INFORM ON CALL ANAESTHETIST

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CAN BE INVESTIGATED MORE

LEISURELY

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REVIEW BY THE SAME TEAM ADVICE FROM OTHER TEAMS EG.

GYNAECOLOGISTS

USS CT DIAGNOSTIC LAPAROSCOPY

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