Tài liệu THE ACUTE ABDOMEN pdf

MOUSTAFA ABOU_ELKHEIR CONSULTANT SURGEON KFHU... Clinical assessment Initial assessment  Reassessment... Does the patient need admission?The risk factors necessitating admission are: 1

THE ACUTE ABDOMEN

Mr MOUSTAFA ABOU_ELKHEIR CONSULTANT SURGEON KFHU

Clinical assessment

 Initial assessment

 Reassessment

Does the patient need admission?

The risk factors necessitating admission are:

1 Abdominal pain of less than 48 hours duration.

2 Abdominal pain followed by vomiting.

3 History of trauma, operation or haemorrhage.

4 History of loss of or impairment of consciousness.

5 Extremes of age.

6 Abnormal physical signs.

The important abdominal findings are:

 Distention

 Guarding/rigidity

 Tenderness/rebound

 Tender mass

 Tender external hernias

 Absent /tingling/hyperactive bowel sounds

 Rectal tenderness/mass

 Emergency Ultrasound

 Emergency CT

 Isotope Scintiscanning

 Abdominal Lavage

 Emergency Laparoscopy

Is the patient underlying condition a of

surgical or medical nature?

Common Septic Conditions:

1. Acute secondary bacterial peritonitis

2. Primary bacterial peritonitis

3. Acute non-bacterial peritonitis

4. Chronic bacterial peritonitis (TB)

5. Chronic non-bacterial peritonitis

(granulomatous)

 Free air after laparotomy, abdominal

paracentesis and peritoneal dialysis

 Gynaecological causes

 After gastrointestinal endoscopy

 Escape of air from tracheobronchial tree

 Pneumatosis cystoides intestinalis

1) SUPPORTIVE MANAGEMENT

2) SURGICAL MANAGEMENT

Mr MOUSTAFA ABOU-ELKHEIR THANK YOU