acute abdomen
DESCRIPTION
akut abdomenTRANSCRIPT
Acute AbdomenDefinition:This is an acute surgical condition caused mainly by a variety ofacute surgical pathology. Abdominal pain arising from alimentary tract is of two types:1. Visceral pain:Which is related directly to the alimentary canal and it's origin either from hind gut or foregut and midgut giving colicky pain.. !eritoneal !ain:"t is somatic type due to peritoneal wall irritation. "t's more severe and more locali#ed."t's due to irritation by underlying inflamed organ e.g. appendi$ or infected free peritoneal fluids e.g. pus.Surgical anatomy of acute abdomen:The abdomen is divided into different anatomical compartments.1.%pper abdomen &ight hypochondriam' (pigastruim and left hypochondruim..)id abdomen: &ight lumber region' umbilical region and left lumber region.*.+ower abdomen &ight iliac fossa' suprapubic region and left iliac fossa.,."nguinal regions:&ight and left inguinal region.Common causes of acute surgical abdomen:1. Acute appendicitis:"t is the most common acute surgical condition in the abdomen. "t affects both se$es e-ually' age incidence. at any age. )a$imum between /0*/ years.!athology:Two types eitherA. 1imple non obstructive:+ess common */2' less serious' catharal or suppurative.3. 4bsturtive appendicitis:"t is due to obstruction of the lumen by fecolith. 1ymptomsare more severe' and complications are more common.5linical picture:A. !ain:6irst generali#ed' periumbilical and then shifted to right iliac fossa. 3. 7ausea and Anore$ia.5. Vomitting. 4nce or more' not repeated.8. 5onstitutional symptoms:malaise' headache and fever.4n ($amination:A. +ocali#ed tenderness at right iliac fossa.3. 9uarding rigidity at right iliac fossa.5. &ebound tenderness due to peritoneal irritation. 5omplication of acute appendicitis:1. Appendicular abscess.. Appendicular mass.*. !eritionitis either locali#ed or generali#ed.8iagnosis:)ainly by clinical e$amination.A.3lood picture.+eucocytosis occurs nearly in */2 of non complicated appendicitis.3.%rine analysis to e$clude urological causes.5.Abdominal %1 to e$clude other causes of acute abdomen.Treatment:"mmediate appendicectomy in uncomplicated appendicitis.Differential Diagnosis of pain in right iliac fossa.1. Acute appendicitis.. Acute mickel's diverticulitis.*. %rological cause.,. 9ynacological causes.:. Tumors in right iliac fossa as cancer caecum.;. 5hronic inflammatory bowel disease as %lcerative colitis and chron's disease.2. Acute cholecystitis:"nflammation of the gall bladder occurs usually as a complication of gall stones. !athology:Two main types:1. Acute non calcular cholecysistis:"t is catarahal' suppurative' or gangeronous. 7o stools.. Acute calcular cholecystitis:"t is due to stone in the gall bladder impacted at