Abdo Pain CSI notes

Question 1

common differentials for abdominal pain (4)

Answer 1

• adhesions
• incarcerated or strangulated hernia
• cholecystitis
• gastric ulcer

Question 2

uncommon differentials for abdominal pain (4)

Answer 2

volvulus
intussusception
duodenal
rupture ovarian cyst

Question 3

patients with evidence of hypovolaemic shock and known or suspected haemoperitoneum management?

Answer 3

• patients with evidence of hypovolaemic shock and known or suspected haemoperitoneum → proceed to surgery quickly with limited peroperative evaluation. patients with ongoing haemorrhage need 2 large bore IV lines to be placed, urgent typing and cross matching of blood and fluid resuscitation. Initial resuscitation typically by 2L of isotonic fluids; O negative uncross matched blood can then be given until cross matched blood available, consider antifibrinolytic, like tranexamic acid

Question 4

• if patient reports abdominal pain disproportionate to signs on physical examination, important to consider what?
• What risk factors would increase the risk of this?

Answer 4

• mesenteric ischaemia

- smoking, peripheral vascular disease, atrial fibrillation

Question 5

what types of foods can exacerbate cholecystitis/cholelithiasis?

Answer 5

fatty foods

Question 6

top 3 differential diagnoses

Answer 6

1. biliary colic
2. ascending cholangitis
3. cholecystitis