Differential diagnosis of inflammatory and ileal acute abdomen
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Non-traumatic acute abdomen (AA) is divided into:
- inflammatory,
- ileus,
- gastrointestinal bleeding,
- gynecological and
- perioperative.
Typical symptoms of inflammatory acute abdomen[edit | edit source]
Subjectively:
- pain persistent, initially visceral (dull, imprecisely localized), later somatic (sharp, localized).
For more information see Types of pain in acute abdomen.Objectively:
- patient maintains an unchanging position, afraid to cough,
- limitation of breathing wave progression,
- abdominal muscular wall contraction (défense musculaire),
- in inflammation of the lower abdomen and small pelvis, painful per rectum examination,
- signs of peritoneal irritation (Plenies, Blumberg, Rovsing).
Laboratory and other findings:
- Increase in body temperature, heart rate, leukocytosis, ↑ FW and CRP (i.e., general inflammatory manifestations).
Typical symptoms of ileus acute abdomen[edit | edit source]
Subjectively:
- colicky pain (mechanical ileus) or persistent pain from distention (advanced obstruction, paralytic ileus),
For more information see Ileus.- vomiting is common (reflex vomiting at the beginning, later from the accumulation of contents),
- stopping the passage of gas and stool.
Objectively:
- the patient frequently changes position, sometimes squeezes his abdomen,
- the abdominal wall is distended, tense, but not contracted,
- the abdomen breathes in its entirety,
- drum percussion,
- listening to the amplification of peristalsis, regular sounds, later ceases (and in paralytic ileus at the beginning),
- per rectum examination mostly painless.
Laboratory and other findings:
- sometimes acceleration of heart rate, body temperature, and leukocytes tend to be normal.
The two basic types of Acute abdomen can intermingle – inflammation is complicated by paralytic ileus, ileus is complicated by inflammation (peritonitis from perforation).
References[edit | edit source]
External links[edit | edit source]
- As. MUDr. Petr Růžička: Ileous acute abdomen E-learning
Related articles[edit | edit source]
- Differential diagnosis of ileus
- Objective symptoms of acute abdomen
- Subjective symptoms of acute abdomen
- Types of pain in acute abdomen
Source[edit | edit source]
- PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 2009]. <<https://langenbeck.webs.com/>>.
