management of the acute abdomen n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Management of the Acute Abdomen PowerPoint Presentation
Download Presentation
Management of the Acute Abdomen

Loading in 2 Seconds...

play fullscreen
1 / 31

Management of the Acute Abdomen - PowerPoint PPT Presentation


  • 348 Views
  • Uploaded on

Management of the Acute Abdomen . Mr Ravi Pararajasingam Consultant Surgeon Manchester Royal Infirmary. Definition. Someone who becomes acutely ill and signs are chiefly related to the abdomen has an acute abdomen. A systematic approach. History, Examination, Investigations, Treatment Plan

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Management of the Acute Abdomen' - niveditha


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
management of the acute abdomen

Management of the Acute Abdomen

Mr Ravi Pararajasingam

Consultant Surgeon

Manchester Royal Infirmary

definition
Definition
  • Someone who becomes acutely ill and signs are chiefly related to the abdomen has an acute abdomen
a systematic approach
A systematic approach
  • History, Examination, Investigations, Treatment Plan
  • May require simultaneous resusitation and treatment.
final diagnosis in uk
Final diagnosis in UK
  • Non-specific abdo pain 30-40%
  • Appendicitis 20-25%
  • Cholecystitis / Biliary Colic 7-8%
  • Peptic ulcer disease 4%
  • Urinary retention 4%
  • Acute pancreatitis 3%
  • Small bowel Obstruction 3%
  • Renal Colic 3%
  • Trauma 3%
  • Malignant disease 2-4%
  • Medical dx 2-4%
  • Acute diverticulitis 2%
  • Large bowel obstruction 2%
  • Vascular Disease 2%
  • Gynaecological disease 1%
history
History
  • Pain: dull, constant, stabbing, pain on movement, colicky pain (comes and goes)
  • Radiation: to right upper quadrant, loin to groin, through to the back
  • History of pain: Initially central than to right iliac fossa
  • Relieveing and exacerbating factors: comes on after eating
  • Associated symptoms: nausea, vomiting, sweats
history of presenting complaint
History of presenting complaint
  • Prior episodes
  • Swellings in groin on abdo
  • Past surgery
  • Gynae / menstrual history ( ectopic pregnency)
  • Vag discharge / PID
  • Past specific illnesses
history1
History
  • Past medical history
  • Past surgical history
  • Drug history and allergies inc alcohol and tobacco
  • Social history/ family history
  • Systemic inquiry
clinical examination
Clinical Examination
  • Look, Feel, Palpate, Percuss:
  • Look: General state & demeanour of patient: sweating, reluctance to move
  • Look: Dehydration, Jaundice, Anaemia, Cynosis, Oedema, Lymphadenopathy
  • Record: Temp, pulse rate, Blood pressure.
  • Rashes: Singles as a cause of acute abdo
clinical examination1
Clinical Examination
  • Examine the abdo, back, groins (hernial orfices), perineum and genitalia.
  • Consider patient’s dignity
  • Clinical Signs: Murphy’s sign, Rovsing sign. Iliopsoas sign.
  • Peritonitis: board like rigidity and silent abdo
clinical examination2
Clinical Examination
  • Cardiovascular and Respiratory Examination:
  • Signs of shock, blood loss, dehydration.
  • MI as a cause of acute abdo
  • Pneumonia as a cause of acute abdo
bedside investigations
Bedside investigations
  • Vomit
  • Stools
  • Urine
  • Pulse Oximetry
basic blood tests
Basic Blood Tests
  • Full Blood Count
  • Urea and Electrolytes
  • Liver Function Tests
  • Bone Profile
  • Amylase
  • Coagulation Screen
  • PREGNENCY TEST
  • MSU
radiology
Radiology
  • Chest X-Ray: Pneumonia, Perforation, Subphrenic abcess
  • Abdominal X-Ray: Ileus, Obstruction, Stones, Air above liver.
  • Contrast studies: gastrograffin, barium enema.
ultrasound
Ultrasound
  • Gallstones, Liver abcess, Biliary tree, Pancreas
  • Urinary Tract: Hydronephrosis, Stones
  • Pelvis: Abcess, appendicitis, Gtynae disease, ectopic pregnancy
  • Ascites
  • Abdominal Aortic Aneurysm
ct scan
CT Scan
  • Useful for retroperitoneal structures
  • Pancreatitis
  • Abdominal Aortic aneurysm
management
Management
  • Resusitate
  • Conservative treatment
  • Medical management
  • Surgical treatment
case 1
Case 1
  • 23 year old lady.
  • Central abdo pain over 48 hours moving to RIF
  • Nausea, Anorexia
case 2
Case 2
  • 40 year old lady
  • Central upper abdominal pain
  • Temperature
  • Jaundice
case 3
Case 3
  • 65 year old man
  • Central abdo pain radiating to the back
  • Hypotensive, Sweaty