Abdominal Emergencies

Question 1

Solid organs

Answer 1

Vascular (contains many vessels and a large amount of blood)

Question 2

Hollow organs

Answer 2

Contain some type of substance (poop) that might leak into the abdominal cavity if the organ is perforated or injured.

Question 3

Mechanisms of Abdominal pain

Answer 3

• Mechanical forces (stretching)
• Inflammation
• Ischemia (organ/tissue hypoxia)

Question 4

Visceral pain

Answer 4

• The organ itself is involved

- Organs do not have large amount of nerves so it’s hard to pin point pain

Question 5

Parietal Pain (somatic)

Answer 5

• Inflammation of the lining of the ABDM cavity (peritoneum)

- More intense

Question 6

Referred Pain

Answer 6

• Visceral Pain felt elsewhere

- Organ shares a nerve pathway with skin

Question 7

Peritonitis

Answer 7

• Inflammation of the peritoneum, lining of the ABDM cavity
• Blood, pus, Bacteria, or chemical substances leak into ABDM cavity
• Effects depends on type of amount of irritant
• Type/Degree of Pain does not indicate severity of the problem

Question 8

Peritonitis S/Sx

Answer 8

• ABDM Pain/tenderness
• N/V
• Diarrhea
• Fever/chills
• Lack of appetite
• ABDM distention

Question 9

Appendicitis

Answer 9

• Inflammation of the appendix
• Usually caused by a blockage
• Untreated the tissue can die and rupture
• Needs surgery

Question 10

Appendicitis S/Sx

Answer 10

• ABDM Pain/cramping can be dull/ diffuse around the navel to start
• Later will be localized to the RLQ
• N/V
• Fever/chills
• Lack of appetite
• ABDM guarding

Question 11

Pancreatitis

Answer 11

• Inflammation of the pancreas
• Severe Pain in the middle of the upper quadrants (epigastric area)
• Some possible light radiation to the back
• Caused by alcohol, gallstones, infections
• Can lead to sepsis, bleeding, tissue death, & sugar regulation issues.

Question 12

Pancreatitis S/Sx

Answer 12

• ABDM Pain
• N/V
• ABDM distention
• Mild jaundice, depending on the cause
• Severe ABDM Pain radiating from navel to back and shoulders
• Fever rapid pulse Sx of shock

Question 13

Cholecystitis

Answer 13

• Inflammation of the gallbladder
• presence of gallstones
• more common in women age 30-50
• Stones can block the opening of the gallbladder to the small intestine
• Need hospitalization possible removal of gallbladder
• Can lead to tissue death & pancreatitis

Question 14

Cholecystitis S/Sx

Answer 14

• Sudden onset of ABDM Pain middle of upper quadrants to RUQ
• More common at night associated with digestion of fatty foods
• Referred Pain R scapula
• Tenderness on palpation of RUQ
• Burps & Heartburn
• N/V May be greenish

Question 15

Gastrointestinal (GI) Bleeding

Answer 15

• Can be upper or lower
• Upper caused by ulcers, and varices
• Upper more common in men
• Lower caused frequently by diverticulosis
• Lower more common in women
• GI bleeding effects people 40-70
• Most death occur after 60

Question 16

GI bleeding S/Sx

Answer 16

• ABDM Pain/tenderness
• (Hematemesis) vomiting blood can be bright red or look like coffee grounds
• (Hematochezia) bright red blood in the stool
• (Melena) dark tarry stools
• ALOC
• Tachycardia
• Sx of shock

Question 17

Esophageal Varices

Answer 17

• Bulging and weakening of the blood vessels in the lower part of the esophagus
• Heavy alcohol drinkers
• Pt’s with liver disease
• Increased venous pressure
• Usually painless

Question 18

Esophageal Varices S/Sx

Answer 18

• Large amounts of bright red blood in the vomit (Be ready to suction)
• No ABDM Pain
• Rapid pulse
• SOB
• Pale, cool, clammy skin
• Sx of shock
• Possible jaundice

Question 19

Gastroenteritis

Answer 19

• Inflammation of the stomach and small intestines
• Result of an infection
• Normally cause by viruses or bacteria
• Can lead to dehydration, hemorrhage, blood in stool and vomit

Question 20

Gastroenteritis S/Sx

Answer 20

• ABDM Pain/cramping
• N/V
• Diarrhea
• Tenderness
• Fever/Dehydration
• Sx of shock with hemorrhage

Question 21

Ulcers

Answer 21

• Open wounds or sores in the digestive tract
• Usually in the stomach or the beginning of the small intestine
• Breakdown the lining of the stomach or intestine leads to bleeding

Question 22

Ulcers S/Sx

Answer 22

• Sudden onset of ABDM Pain
• LUQ and epigastric area, described as burning
• N/V
• Blood in poop/ vomit
• Sx of shock
• Rigid ABDM

Question 23

Abdominal aortic aneurysm (AAA)

Answer 23

• weakened, Balloon area of the ABDM aorta
• same causes and Sx as aortic aneurysm just located lower in the ABDM
• The EMT May not be able to tell the difference
• Must get to surgery
• Tx is position of comfort

Question 24

AAA S/Sx

Answer 24

• Gradual onset of lower lumbar, groin, ABDM Pain, acute pain with rupture
• Radiating “tearing” pain to go back
• Pale cool, clammy skin Sx of shock
• Possible Cyanosis below rupture site
• Unequal BPs and pulses
• Late Sx pulsating mass