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    Clinical Approach To Acute Abdominal Pain

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    Rhomizal Mazali
    1. Acute abdomen refers to sudden abdominal pain that may require urgent intervention and encompasses a variety of surgical, medical, and gynecological conditions characterized by pain for less than one week. 2. Abdominal pain can originate from many organs in the abdomen and be felt as visceral, parietal, or referred pain depending on the underlying cause and pathways involved. 3. A thorough history and physical exam are important to evaluate characteristics of the pain like location, severity, exacerbating/relieving factors, associated symptoms, and past medical history to help determine the potential cause.

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    Clinical Approach To Acute Abdominal Pain

    Uploaded by

    Rhomizal Mazali
    172 views18 pages
    1. Acute abdomen refers to sudden abdominal pain that may require urgent intervention and encompasses a variety of surgical, medical, and gynecological conditions characterized by pain for less than one week. 2. Abdominal pain can originate from many organs in the abdomen and be felt as visceral, parietal, or referred pain depending on the underlying cause and pathways involved. 3. A thorough history and physical exam are important to evaluate characteristics of the pain like location, severity, exacerbating/relieving factors, associated symptoms, and past medical history to help determine the potential cause.

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    Clinical Approach to Acute Abdominal Pain

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    Clinical Approach to Acute Abdominal Pain

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    1. Acute abdomen refers to sudden abdominal pain that may require urgent intervention and encompasses a variety of surgical, medical, and gynecological conditions characterized by pain for less than one week. 2. Abdominal pain can originate from many organs in the abdomen and be felt as visceral, parietal, or referred pain depending on the underlying cause and pathways involved. 3. A thorough history and physical exam are important to evaluate characteristics of the pain like location, severity, exacerbating/relieving factors, associated symptoms, and past medical history to help determine the potential cause.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    172 views18 pages

    Clinical Approach To Acute Abdominal Pain

    Uploaded by

    Rhomizal Mazali
    1. Acute abdomen refers to sudden abdominal pain that may require urgent intervention and encompasses a variety of surgical, medical, and gynecological conditions characterized by pain for less than one week. 2. Abdominal pain can originate from many organs in the abdomen and be felt as visceral, parietal, or referred pain depending on the underlying cause and pathways involved. 3. A thorough history and physical exam are important to evaluate characteristics of the pain like location, severity, exacerbating/relieving factors, associated symptoms, and past medical history to help determine the potential cause.

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    Clinical approach to acute abdominal pain

    By Dr : Allah Obhayo Unar Department of surgery USM

    Acute abdomen

    Definitions :It is a clinical syndrome , characterized by abdominal pain of great severity , which might necessitate urgent intervention An acute abdomen denotes any sudden , spontaneous , non-traumatic disorder

    Acute abdomen

    Acute abdomen is a term used synonymously for a condition that needs surgical intervention Term used to encompass a spectrum of surgical, medical , and gynaecological conditions Abdominal pain of less than 1 week duration

    Abdominal pain

    Pain is an un pleasant sensory and emotional experience Pain fibers are A delta and C class of peripheral nerves

    Abdominal pain

    Stomach Biliary tree Small intestine Colon Kidney Cervix Bladder Rectum

    T5 7 T6 8 T8 10 T10 L1 T10 L1 S2 4 S2 4 S2 4

    Classification

    Visceral pain Parietal pain Referred pain

    Visceral pain

    It is perceived through neuronal pathways from lower thoracic and lumber splanchic nerves and parasympathetic pathways of vagus and sacral plexus Sensation / feeling is produced in response to stretch or distension of walls of hollow organs and capsule of solid organs

    Visceral pain

    It may be due to pull or twist of mesentery It is usually dull aching / colicky / griping in nature Associated symptoms may be , - Nausea - Vomiting - Sweating

    Visceral pain

    It is poorly localized in - Epigastric region - Peri- umbilical region - Hypo gastric region

    Parietal pain

    Somatic nerves supplying adjacent abdominal wall structures and skin , there fore it is , - steady - Localized - Intense - Burning in nature

    Referred pain

    Due to local irritation with referred along the nerves of innervations of the organ Origin ( primary site ), Perceived pain ( secondary pain)

    Evaluation of abdominal pain


    Time , < 6 hours , > 6 hours Mode of onset , sudden / slow Location of pain, RUQ, LUQ, RLQ, LLQ Shifting of pain , from peril umbilical to RIF Severity of pain , 1--- 10 , Character of pain , burning, cutting, griping Exacerbating factors / Relieving factors

    What questions to be asked?


    Have you had this pain before ? On scale from 1 to 10 , what would you rank this pain ? Fevers / chills? Duration ? (comes and goes versus constant) Quality ? (sharp versus dull)

    What questions to be asked ?


    Does any thing make the pain better or worse ? Migration ? Point of maximal pain ? Urinary symptoms ? Nausea , vomiting , or diarrhea ? Anorexia ?

    What questions to be asked ?


    Constipation ? Last bowel movement ? Any change in bowel habits ? Last menses? Last meal ? Vaginal discharge ? Malena ?

    What question to be asked ?


    Hematochezia ? Hematemesis ? Medications ? Allergies ? Past medical history ? Past surgical history ? Family history ?

    What makes it better ?


    Medication Eating or drinking Heat Urinating or bowel movements Sleep Position change Nothing

    What makes it worse ?


    Eating or drinking Lying down Urinating or bowel movements Position change Nothing

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