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Abdominal Pain Acute Abdomen: Prof JHR Becker Department Chirurgie

This document discusses abdominal pain caused by acute conditions requiring hospital admission for less than one week. Approximately 50% of surgical admissions are for acute abdominal pain, which can be caused by surgical, medical, or gynecological issues. The pain can be somatic, arising from the skin or muscles, or visceral, arising from internal organs. A clinical assessment of the patient should examine factors like the pain location, nature, onset, severity, and effect of movement to determine the potential cause.

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Sutapa Pawar
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44 views21 pages

Abdominal Pain Acute Abdomen: Prof JHR Becker Department Chirurgie

This document discusses abdominal pain caused by acute conditions requiring hospital admission for less than one week. Approximately 50% of surgical admissions are for acute abdominal pain, which can be caused by surgical, medical, or gynecological issues. The pain can be somatic, arising from the skin or muscles, or visceral, arising from internal organs. A clinical assessment of the patient should examine factors like the pain location, nature, onset, severity, and effect of movement to determine the potential cause.

Uploaded by

Sutapa Pawar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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ABDOMINAL PAIN

ACUTE ABDOMEN
PROF JHR BECKER
DEPARTMENT CHIRURGIE
Abdominal pain that requires
• Hospital admission
• Investigation and treatment
• less than one week duration
ACUTE ABDOMEN
• 50% of Surgical admissions are
emergencies
• 50% of that is acute abdominal pain
• 30 day mortality is 4%
• if operated rises to 8%
ACUTE ABDOMEN
• CAUSES
– Surgical
– Medical
– Gynaecological
SURGICAL
• Related to the
– organ
– pathology
TYPES OF PAIN
• Visceral
• Somatic
SOMATIC
• Dermatomes, Pain C3-5, T5 – L2
• Mechanical)
• Thermal ) Causes
• Chemical )
• Reflex contraction
– rigidity
– guarding
– hyperaesthesia
VISCERAL PAIN
• Insensitive to the above
• Sensitive to
– Overdistension
– Traction
– Visceral muscle spasm
– Ischaemia
NATURE OF THE PAIN
• Somatic is Sharp or Knife-like
• Visceral – dull and deep seated
– Somatic - Dermatome
– Visceral
• Foregut - Epigastrium
• Midgut - Umbilical
• Hindgut - Hypogastrium
CLINICAL ASSESSMENT
• Site of pain (11 areas) (9+2)
• Nature of pain
– Obstruction
– Inflammation
OBSTRUCTION
• Colic/Spasms/Gripping
• Move around, draw up
• Knees etc.
INFLAMMATION
• Pain does not disappear
• Becomes continuous
• Incarceration becomes strangulation
RADIATION OF THE PAIN
• Other structures are getting involved eg.
D.U. to the back
• Kidney stone to the perineum
ONSET OF PAIN
• Sudden – acute – eg. P.U. perforation
SEVERITY
• Personality differences
• Consult G.P.
• Went to work
• Lie down
PROGRESSION
• Same for days
• Gets worse
• Fluctuate
MOVEMENT
• e.g. Appendicitis
EXAMINATION
• INSPECTION:
– Exposure (Chest to inguinal)
– Swellings
– Scars
– Distended veins
– Intestinal peristalsis
PALPATION
• Voluntary guarding
• Involuntary guarding
• Board-like rigidity
• Rebound tenderness (Cough-test)
PERCUSSION
• Resonance
• Dull
• Pain
• Shifting dullness
AUSCULTATION
• Normal bowel sounds
• Decreased
• Increased

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