Acute Abdomen
Acute Abdomen
Acute Abdomen
-Surgical. -Medical.
-Gynecological.
*Surgically:
1-Inflammation. Peritonitis
2-Obstruction. Intestinal obs
3-Ischaemia.
4-Perforation.perforated PU .
:Site*
*The structure that cause pain in the upper
zone:-
Stomach
&
Gall
duodenum Pancreas
bladder
The structure that cause pain in the central*
:-zone
Small bowel
Caecum
Kidney
Kidney
Retroperitoneal
structure
The structure that cause pain in the lower*
:-zone
Transverse colon
Appendix Sigmoid
Ca & Bladder
ec Colon
&
um
uterus
:-Nature*
It divided into:-
1-condition associated with inflammation.
2-condition associated with obstruction.
Physiology of abd pain
Def :-
Pain is the physical adjunct of an imperative
protective reflex .
*pain has three component :-
1-motor reaction
2-emotional reaction .
3- autonomic reaction.
:-Pain qualities
Pricking pain Burning pain
1-fast acute pain 1-slow pain
-tongue -ear
-teeth -head
-hip -knee
-Preumbilical colic.
-Pain shift to the right iliac fossa.
-Anorexia.
-Nausea & vomiting
*C\s in appendicitis:-
-Pyrexia.
-Localized tenderness in right iliac fossa.
-Muscle guarding.
-Rebound tenderness.
:-signs to elicit in appendicitis*
-Pointing sign.
-Rovsing`s sign.
-psoas sign.
-obturater sign.
; Alverado score
Symptoms ; Score ;
1. Migratory RIF pain . 1
2. Anorexia . 1
3. Nausea and vomi . 1
Signs ;
1. Tenderness RIF .
2
2. Rebound T .
1
3. Elevated T .
1
Lab :
1. Leuk .
2
2. Shift to the left .
total 1
10
Management of acute appendicitis
Acute pancreatitis
Def;
Aetiology :
common ; gallstones , periampullary
carcinoma and alcohol .
uncommon ;
Pathology :
basicly enterokinase activation of
pancreatic enzymes autodigestion .
finally pancreas become swollen , hrrgis
,necrotic and suppurative
:-C\F of acute pancreatitis*
*Pain is cardinal Vomitting.
symptoms: Ab. tenderness and
-Site . guarding
-Nature. Temperature
-Severity. Jaundice 30%
-Radiation. Grey turner’s singe
-Aggravated factor.
Cullen’s singe .
-Reliving factor.
shock
:-O\E
-Pt look ill, tachypnea, tachycardia.
-Hypotension, mild jaundice.
-Temperature normal or abnormal.
-Grey turner sign.
-Cullen's sign.
-Red tender nodules on legs.
-Abdominal distension.
Complication
Investigation
Treatment
Prgnosis
:-Treatment of Acute pancreatitis*
Mild +Sever+
).Conserve. (Ranson criteria -
.ICU admission -
. analgesics + -
.N.B.M -
.Antibiotic -
.Chart -
. Deteriorate
.Laprotomy
Definition
C/F
O/E
D.D
Management
Complication
Investigation
;Perforated peptic ulcer
c\f
Investigation
Treatment
:-peritonitis*
Def of peritoneum ;
Types of the peritoneum ;
Causes of the peritoneal inflammatory exudate ;
1. Bacterial infection
2. Chemical injury
3. Ischemic injury
4. Direct trauma
5. Allergic reaction
:Acute peritonitis
Bacteriology ;
Route of infection
Clinical \F of localized perit
1. Initial symptoms and signs .
2. Fever
3. Abdominal pain .
4. Vomitting
5. Sings ; PR -- guarding and rigidity –
positive rebound tenderness
;Diffuse peritonitis
Symptoms
Signs
Investigation & management
Complications .
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