Acute abdomen
From WikiLectures
Acute Abdomen are serious conditions that arise suddenly, from full health, and have a very rapid course. Without timely treatment, they can be life-threatening. An important criterion for subsequent treatment is a quick but accurate determination of the underlying diagnosis. All examinations must be carried out thoroughly and systematically.
Distribution of acute abdomen[edit | edit source]
Accidental acute abdomen[edit | edit source]
- rupture of parenchymal organs (hemoperitoneum)
- perforation of hollow organs
- mixed form
Non-accidental acute abdomen[edit | edit source]
- inflammatory (limited to the organ/with transition to the surroundings, diffuse peritonitis)
- ileus (mechanical/ neurogenic/ vascular ileus)
- vascular - venous thrombosis, arterial embolization, bleeding into the GIT
Symptomatology[edit | edit source]
- pain
- subfebrile, or febrile
- tachycardia, tachypnea
- nausea, vomiting
- abdominal distension
- stiff, tense abdominal wall
- patient position
- gas and stool disorders
Basic examination[edit | edit source]
Anamnesis[edit | edit source]
- CC (chief complaint) – development and nature of difficulties, time of onset of difficulties
- Illnesses, operations, traumas
- Allergies
- Family diseases
- Past medical history
- Social history (medicine), including living arrangements, occupation, marital status, number of children, drug use (including tobacco, alcohol, other recreational drug use), working conditions
- GA – in woman (Sexual history, obstetric/gynecological)
- direct - taken from the patient
- indirect - taken from family, paramedics, friends...
For more information see Anamnesis.Clinical examination[edit | edit source]
View
- we always examine the entire abdomen, from the nipples to the inguinal ligaments (signs of a hernia)
- we observe the level of the abdomen - whether it is raised or sunken
- we notice wounds, bruises, scars
- we observe peristaltic waves
- we observe the breath wave
- abdominal configuration
Feel
- we start the investigation on the opposite side from the pain
- we detect muscle contraction, resistance and soreness
- border of liver and spleen
- surface palpation with the whole hand, palpation with 1 or 2 fingers, deep palpation
Percussion
- differentiated tympanic
- tympanic
- dark
- we notice a painful tap
Listening
- silence
- irregular sounds
- strenuous peristalsis
- the sound of a drop falling
- splash
For more information see Abdominal Examination.- surroundings of anus
- pain
- sphincter tone
- stool
- bleeding
For more information see Examination per rectum.Paraclinical examination[edit | edit source]
- X-ray – use of contrast material / native image of the abdomen (standing)
- USG
- CT
- colonoscopy
- ECG
- laboratory examination – urine, blood count, hematocrit, sedimentation, biochemical blood analysis
Links[edit | edit source]
Related Articles[edit | edit source]
- Objective symptoms of acute abdomen
- Subjective signs of acute abdomen
- Differential diagnosis of inflammatory and ileal acute abdomen
- Acute abdomen in gynecology
- Acute abdomen in children
- Differential diagnosis of ileous conditions
- Types of pain in acute abdomen
- Diagnostic imaging of the acute abdomen
Resources[edit | edit source]
- ZEMAN, Miroslav – KRŠKA, Zdeněk. Chirurgická propedeutika. 3. edition. Grada, 2011. ISBN 978-80-247-3770-6.
- SLEZÁKOVÁ, Lenka. Ošetřovatelství v chirurgii II. 1. edition. Grada, 2010. ISBN 978-80-247-3130-8.
- KELNAROVÁ, Jarmila. První pomoc II. 1. edition. Grada Publishing, 2007. 184 pp. ISBN 9788024721835.
