MEDI7302 Study Guide - Final Guide: Hemoperitoneum, Peritonitis, Urinary Retention
Acute Abdomen
Introduction Sudden, severe abdominal pain in the presence of tenderness and rigidity, hence
signalling a surgical emergency
5 main causes = inflammation, perforation, haemorrhage, ischaemia, obstruction
Types of pain
Somatic Spinal nerves (intercostal branches of T5-T11) from
parietal peritoneum
Sharp, intense, well localised pain
Visceral Autonomic (coeliac plexus, lumbar trunk) pain of
organs
Diffuse, poorly localised pain (typically midline)
Referred Biliary colic causes RUQ pain (gallbladder site) that
refers to tip of scapula
Renal colic causes loing to groin pain
Location of
pain
Generalised Ischaemic gut
Perforated peptic ulcer
Perforation of other intrabdominal organs
AAA rupture
Aortic dissection
Pancreatitis
Ectopic pregnancy
Epigastric GIT - dyspepsia, gastritis, reflux oesophagitis, Booerhaarve disease
(esophageal rupture), PU, pancreatitis, gastric or pancreatic cancer, IBS
Cardiac - MI, pleuritis
Pulmonary - pneumonia, pleurisy
Central Acute small bowel ischemia
Acute small bowel obstruction
Acute appendicitis
Acute pancreatitis
Testicular torsion
RUQ Gallbladder - biliary colic, cholecystitis, cholangitis
Liver - hepatitis, hepatomegaly, hemorrhage into hepatic tumour,
abscess, Fitz-Hugh-Curtis (perihepatitis via PID), pre-eclampsia and HELLP
GIT - appendicitis with high appendix (pregnancy), perforated
duodenal ulcer, colon cancer
Pulmonary - RLL pneumonia, pleurisy, subphrenic abscess
Acute pyelonephritis
LUQ Subphrenic abscess
Pancreatitis
Diverticulitis
Ruptured spleen
Leaking aneurysm of splenic artery
Acute gastric distension
Acute pyelonephritis
RIF GIT - appendicitis, cholecystitis, mesenteric adenitis, Meckel's
diverticulum, Crohn's disease, colon cancer, constipation, IBS
Reproductive (female) - ectopic pregnancy, ovarian cyst rupture/
hemorrhage/ torsion, Mittelschmerz (ovalation pain mid-cycle), PID,
endometriosis
Reproductive (male) - seminal vesiculitis, undescended testis
Urinary - renal colic, UTI
Hip pathology, psoas abscess
RLL pneumonia
LIF GIT - diverticulitis, colitis, colon cancer, constipation, IBS
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Sudden, severe abdominal pain in the presence of tenderness and rigidity, hence signalling a surgical emergency. 5 main causes = inflammation, perforation, haemorrhage, ischaemia, obstruction. Spinal nerves (intercostal branches of t5-t11) from parietal peritoneum. Biliary colic causes ruq pain (gallbladder site) that refers to tip of scapula. Git - dyspepsia, gastritis, reflux oesophagitis, booerhaarve disease (esophageal rupture), pu, pancreatitis, gastric or pancreatic cancer, ibs. Liver - hepatitis, hepatomegaly, hemorrhage into hepatic tumour, abscess, fitz-hugh-curtis (perihepatitis via pid), pre-eclampsia and hellp. Git - appendicitis with high appendix (pregnancy), perforated duodenal ulcer, colon cancer. Git - appendicitis, cholecystitis, mesenteric adenitis, meckel"s diverticulum, crohn"s disease, colon cancer, constipation, ibs. Git - diverticulitis, colitis, colon cancer, constipation, ibs. Reproductive (female) - ectopic pregnancy, ovarian cyst rupture/ hemorrhage/ torsion, mittelschmerz (ovalation pain mid-cycle), pid, endometriosis. Renal - pyelonephritis or cystitis, renal colic, renal carcinoma, renal. Acute appendicitis (anorexia, cough pain, sharp tenderness in rlq) Gall stone ileus (gallstone enters duodenum via fistula)
