Acute Abdomen

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Acute Abdomen
The Role of the Physician
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Acute Abdomen Triage
Surgical Emergent Urgent Semi-urgent Non-operativ
e
Medical Medical Therapy Elective Surgery
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Acute Abdomen Bleeding
External Internal-
Ectopic Ruptured Aneurysm Ruptured Spleen/Liver
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Acute Abdomen Diagnosis
History 65 Physical Examination 15 Special
Investigations 10 Autopsy 5 G.O.K.
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Acute Abdomen 1952-2007
CT Scan of Abdomen and Pelvis The most
significant advance in the diagnosis of the acute
abdomen
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Acute Abdomen Extra-Abdominal Causes of Pain

• Cardiopulmonary
• Neurogenic
• Metabolic- Toxic
• Miscellaneous

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The Senses Common Sense Sight Touch Hearing Smell
Taste
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Acute Abdomen
Not only must you listen but you must hear. Not
only must you look but you must see. Not only
must you touch but you must feel.
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Acute Abdomen Surgical Pathology
Functional Organic In the lumen In the wall
(C,T,I,N,V, etc.) Outside the
wall Displacements
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Acute Abdomen Surgical Causes
Block-Pain, vomiting, distension and
obstipation Bleed Burst
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Acute Abdomen History
Pain Appetite Vomiting Bowels Micturition Menses
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Acute Abdomen History
PMH Medications Allergies
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Acute Abdomen Signs
Observe patient Vital signs Bowel
sounds Tenderness, guarding and rigidity Masses
and visceromegaly Hernial orfices and genitalia PR
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Acute Abdomen Special Investigations

• CBC and Urine
• Blood Chemistry and HCG
• Chest X-ray
• KUB
• Scans
• Contrast Studies
• Endoscopy

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Acute Abdomen D/D Acute Appendicitis
Gyn (PID, Ovarian cysts, Ectopic) IBD (Crohns
and Yersinia) Gastroenteritis Kidney stone and
Pyelonephritis Meckels Divert Cecal
Diverticulitis Perf PUD Perforated Cecal Ca
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Acute Abdomen Acute Cholecystitis
Biliary Colic Empyema or Hydrops Gangrene W/U ?
US and HIDA
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Acute Abdomen Stone in CBD


Pain Jaundice Charcots Reynolds Fever Triad
Pentad Septic Shock Change in Mental Status
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Acute Abdomen Acute Pancreatitis The Great
Mimicker
MI Perf PUD Acute Cholecystitis S.B.O. Ruptured
Aneurysm Ischemic Bowed Disease
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Acute Abdomen Small Bowel Obstruction
Adhesions Hernia
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Acute Abdomen Large Bowel Obstruction
Carcinoma Volvulus Diverticulitis
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Acute Abdomen Acute Diverticulitis
Inflammation Abscess Perforation
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