Abdominal pain
Peritonism = inflammation
NOTE: Generalised abdo pain + worse on movement = peritonisim
NOTE: NSAID + corticosteroid = peptic ulcer disease
Obstruction
Investigations
Imaging:
NOTE: If WCC drops, consider overwhelming sepsis (in young and elderly)
NOTE: If wall and interior of bowel visible on XR, consider free gas
NOTE: *** If perforation, do not use barium contrast. Toxic to peritoneum***
NOTE: *** If suspect bowel obstruction, give enema, NOT oral prep ***
Source
Dr David Lloyd
- Perforated PUD
- Ruptured appendix
- Perforated diverticulum
- Pancreatitis
- Sepsis
- UTI (in elderly it can mimic a lot of things)
NOTE: Generalised abdo pain + worse on movement = peritonisim
NOTE: NSAID + corticosteroid = peptic ulcer disease
Obstruction
- Most common = adhesion
- volvulus
- ca (if virgin abdo + SBO, think caecal ca)
Investigations
Imaging:
- XR - erect/ decubitus to check free gas
NOTE: If WCC drops, consider overwhelming sepsis (in young and elderly)
NOTE: If wall and interior of bowel visible on XR, consider free gas
NOTE: *** If perforation, do not use barium contrast. Toxic to peritoneum***
NOTE: *** If suspect bowel obstruction, give enema, NOT oral prep ***
Source
Dr David Lloyd