Links:
The Practice Guidelines for Primary Care of Acute Abdomen 2015
ACG Clinical Guideline: Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)
Sudden, severe, abdominal pain of unknown etiology. Several cases require surgical intervention.
H&P
- Appendicitis (periumbilical pain that migrates to the RLQ)
- Ascending Cholangitis (Charot’s Triad: fever, jaundice, RUQ pain / Reynold’s Pentad: + shock, AMS)
- AAA (pulsatile mass, pain radiating pain to back)
- Mesenteric Ischemia (pain out of proportion to exam)
- Bowel Obstruction (small: n/v, colicky pain / large: feculent emesis)
- Others: PUD/gastritis, Choleycystitis, Diverticulitis, Pancreatitis, Pneumonia/PE, Ovarian Cyst
EXAM
When to be worried
- Unstable vital signs
- Signs of peritonitis
- Other life-threatening diagnoses possible (MI, bowel obstruction, ectopic pregnancy, mesenteric ischemia)
TREATMENT
- Pain management with opiates
- Resuscitation
- Early Consultation