Acute Abdomen 1

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Acute Abdomen&Abdominal Trauma : 

Acute Abdomen&Abdominal Trauma

Abdominal Pain : 

Abdominal Pain Common What is causing it? Life-threatening?

Acute Abdomen : 

Acute Abdomen Sudden onset of abdominal pain Indicates peritoneal irritation

Anatomy : 

Anatomy Gastrointestinal System Look it Up! Renal or Urinary System Reproductive System Male Female

The Abdomen (1 of 2) : 

The Abdomen (1 of 2) The abdomen is the second major body cavity. It contains the major organs of digestion and excretion.

The Abdomen (2 of 2) : 

The Abdomen (2 of 2)

Description of Abdominal Pain : 

Description of Abdominal Pain Local General or diffuse Referred Colic

GI Bleeding : 

GI Bleeding Pain “heartburn” Signs of shock And the following types of bleeding

Bright red rectal bleeding : 

Bright red rectal bleeding indicates bleed close to anus. obvious sign ( not subtle ) minor bleeds usually hemorrhoid

Melena : 

Melena Dark, tar-like stools Lower GI bleed Can be only indication of GI bleed can represent significant blood loss

Coffee ground emesis : 

Coffee ground emesis Partially digested blood chronic stomach or duodenum

Bright red emesis : 

Bright red emesis upper Gi bleed above stomach Think Esophageal varices Can be severe

GI complaints : 

GI complaints Common signs & symptoms

Hemorrhoid : 

Hemorrhoid Enlarged blood vessels near the anus. Rectal pain bleeding

Ulcer : 

Ulcer Erosion of the stomach or intestinal lining. Epigastric or abdominal pain Hematemesis – blood in emesis Bright red Coffee ground

Hernia : 

Hernia Protrusion of tissue through body wall pain red or blue skin discoloration incarcerated can be serious medical emergency

Esophageal Varices : 

Esophageal Varices enlarged blood vessels in the esophagus that can rupture massive bright red bleeding (oral) Shock Hx of liver disease or ETOH abuse

Bowel Obstruction : 

Bowel Obstruction A blockage of the bowel lumen prohibiting the passage of material Hx of recent abdominal surgery constipation colicky abdominal pain abdominal distention Nausea/Vomiting

Appendicitis : 

Appendicitis Inflammation of the appendix fever anorexia N/V RLQ pain Rebound tenderness

Cholecystitis : 

Cholecystitis Inflammation of the gallbladder Gallstones? recent ingestion of fatty food? RUQ pain gradual onset not colicky pain

Kidney Stones : 

Kidney Stones Calculi in the kidney severe flank pain maybe colicky restlessness nausea & vomiting

Urinary Tract Infection (UTI) : 

Urinary Tract Infection (UTI) Bacterial infection in the urinary tract Lower abdominal pain Pain and/or burning with urination Hematuria Urgency and frequency

Pyelonephritis : 

Pyelonephritis Inflammation of the kidney Flank pain Pain and/or burning with urination Hematuria Fever

Pelvic Inflammatory Disease : 

Pelvic Inflammatory Disease The inflammation of the female pelvic organs (STD) Dull RLQ or LLQ pain abnormal vaginal discharge nausea & vomiting fever

Ectopic Pregnancy : 

Ectopic Pregnancy Embryo gestation outside uterus (usually fallopian tube) RLQ or LLQ pain late LMP may have vaginal bleeding shock

Peritonitis : 

Peritonitis Inflammation of the peritoneum Generalized abdominal pain Fever Rigid abdomen Nausea and/or vomiting Distention

Dissecting Abdominal Aortic Aneurysm : 

Dissecting Abdominal Aortic Aneurysm Aneurysm develops between arterial layers shearing/tearing abdominal pain sudden onset shock unequal femoral pulses

Assessment : 

Assessment OPQRST - all pain is not the same SAMPLE or HAM nausea, vomiting, diarrhea anorexia fever weakness or syncope

The physical exam : 

The physical exam observe for distention palpate for TRPGR check all 4 quadrants start away from pain

Females : 

Females Always consider a gynecological problem with women having abdominal pain Pregnant? LMP Normal? Prior gynecological problems

Treatment : 

Treatment oxygen position of comfort no oral fluids monitor vitals carefully transport treat for shock PRN

Notes : 

Notes Dialysis shunts / fistulas kidneys role in homeostasis digestive “juices” = hydrochloric acid

Notes : 

Notes nasogastric tubes (NG tubes) gastrointestinal tube (GI tubes) colostomy / illeostomy

Abdominal Trauma : 

Abdominal Trauma Penetrating & Blunt

Abdominal Anatomy : 

Abdominal Anatomy look it up in your text book Hollow organs Solid organs

Solid organs : 

Solid organs Liver Spleen Kidneys Pancreas

Hollow Organs : 

Hollow Organs Stomach Intestines Bladder

Which quadrant is it in? : 

Which quadrant is it in? stomach liver spleen intestine

Which quadrant is it in? : 

Which quadrant is it in? kidney bladder appendix

Injuries of the Abdomen : 

Injuries of the Abdomen Closed injury (blunt) Open injury (penetrating)

Signs & Symptoms : 

Signs & Symptoms Mechanism Pain - pain upon palpation Tachycardia Shock Bruising Distended or rigid abdomen Nausea & vomiting

The Physical Exam : 

The Physical Exam Determine type of injury Observe for distention Palpate (TRPGR) Check all 4 quadrants Start away from pain

Treatment of all abdominal injuries : 

Treatment of all abdominal injuries High flow O2 Keep airway clear Treat for shock prn No oral fluids Rapid transport Supine / shock

Care for Penetrating Injuries : 

Care for Penetrating Injuries Check for exit wounds. Dry sterile dressing Bulky dressing for impaled object

Abdominal Evisceration : 

Abdominal Evisceration Internal organs or fat protrude through the open wound. Never try to replace organs. Cover with moist gauze, then sterile dressing. Keep organs warm and moist. Transport promptly.

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