The Acute Abdomen

1
Chapter 14

• The Acute Abdomen

2
Objectives (1 of 2)

• Define the term acute abdomen.
• Identify the signs and symptoms of the acute
  abdomen and proper care.
• Define the concept of referred pain.

3
Objectives (2 of 2)

• Describe areas of pain or referred pain
  associated with common causes of acute abdomen.
• Explain how pain in the abdomen can arise from
  problems in other body systems.

4
Physiology of the Abdomen (1 of 2)

• Acute abdomen
• Sudden onset of abdominal pain
• Peritoneum
• Thin membrane lining the entire abdomen
• Colic
• Severe, intermittent cramping pain

5
Physiology of the Abdomen (2 of 2)

• Referred pain
• Perceived pain at a distant point of the body
  caused by irritation of the visceral peritoneum
• Peritonitis
• Irritation of the peritoneum caused by illness or
  injury

6
Signs and Symptoms of Acute Abdomen (1 of 2)

• Abdominal pain and/or tenderness
• Quiet patient guarding the abdomen (shock)
• Rapid and shallow breathing
• Referred (distant) pain
• Anorexia, nausea, vomiting

7
Signs and Symptoms of Acute Abdomen (2 of 2)

• Tense, often distended abdomen
• Sudden constipation or bloody diarrhea
• Tachycardia
• Hypotension
• Fever
• Rebound tenderness

8
Examining the Abdomen

• Explain what you are about to do.
• Position the patient supine with legs drawn up
  and knees flexed.
• Observe the patient.
• Gently palpate the abdomen.
• Determine if the patient can relax the abdominal
  wall on command.
• Determine if abdomen is tender when palpated.

9
Causes of Acute Abdomen

• Substances lying in or adjacent to the abdominal
  cavity
• Other common causes
• Appendicitis
• Perforated gastric ulcer
• Cholecystitis
• Diverticulitis

10
Uterus and Ovaries

• Always consider a genealogical problem with women
  having abdominal pain
• Causes of pain
• Menstrual cycle
• Pelvic inflammatory disease
• Ectopic pregnancy

11
Other Organ Systems

• Aneurysm
• Weakness in aorta
• Pneumonia
• May cause ileus and abdominal pain
• Hernia
• Protrusion through a hole in the body wall

12
Emergency Medical Care (1 of 2)

• Do not delay transport.
• Do not attempt to diagnose.
• Clear and maintain the airway.
• Anticipate vomiting.
• Administer oxygen.
• Give nothing by mouth.

13
Emergency Medical Care (2 of 2)

• Document all pertinent information.
• Anticipate the development of hypovolemic shock.
• Make the patient comfortable.
• Monitor vitals signs.

14
Geriatric Needs

• Decreased pain perception
• May not have fever with infection
• May delay seeking care because pain is minimal
• Assess carefully.